Different Mechanistic Association of Myopia with Rhegmatogenous Retinal Detachment between Young and Elderly Patients.

Sang Jun Park,Kyu Hyung Park,Se Joon Woo,Min Seok Kim

doi:10.1155/2019/5357241

Sang Jun Park, Kyu Hyung Park + Show 2 more

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https://doi.org/10.1155/2019/5357241

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Abstract

Objectives To investigate the mechanism of rhegmatogenous retinal detachment (RRD) in young and elderly Korean patients based on the results of axial length distribution. Subjects/Methods We retrospectively reviewed the medical records of 1599 patients with RRD who had bilateral axial length data examined at one center between 2003 and 2018. Axial lengths were measured using ultrasound or IOLMaster500. The frequency of RRD and axial length distribution according to age groups were investigated. Results Patients with RRD displayed a bimodal distribution across ages with two age groups showing the highest peak at 55–59 years and a second peak at 25–29 years of age. The mean axial length was significantly longer in patients younger than 50 years old than that in patients ≥ 50 years old (26.18 ± 1.86 mm vs. 24.55 ± 1.67 mm, respectively, p < 0.001). The percentage of patients with high myopia (axial length ≥ 26 mm) in patients < 50 years old was higher than that in those ≥ 50 years old (51.9% vs. 15.0%, respectively, p < 0.001; odds ratio, 6.11; 95% confidence interval, 4.83 to 7.74). Conclusions We found a difference in the prevalence of myopia between young and elderly patients with RRD, which corresponds to a bimodal distribution of RRD incidence in East Asian countries. Our data indicate that myopia or high myopia-induced early vitreous detachment appears to be a major mechanism of occurrence of RRD in young East Asian patients, while senile vitreous liquefaction and detachment is the main mechanism of RRD in elderly patients.

Highlights

Rhegmatogenous retinal detachment (RRD) is characterized by the separation of the inner neurosensory retina from the outer retinal pigment epithelium resulting from one or more full-thickness retinal breaks
The mean axial length was relatively long in patients aged 10–50 years and decreased with age in patients with RRD (Table 2, Figure 2(b))
Two RRD peaks correlating with age and axial length distribution showed a similar pattern between sexes

Summary

Introduction

Rhegmatogenous retinal detachment (RRD) is characterized by the separation of the inner neurosensory retina from the outer retinal pigment epithelium resulting from one or more full-thickness retinal breaks. Three essential features are required for the occurrence of RRD: (1) liquefied vitreous gel; (2) traction forces that can produce a retinal break; and (3) the presence of a retinal break that allows passage of liquefied vitreous into the subretinal space [1]. Vitreous syneresis, which induces posterior vitreous detachment, can produce all three features that lead to RRD. Spontaneous RRD is usually preceded by posterior vitreous detachment. An increasing trend is observed in the prevalence of posterior vitreous detachment with age.

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