Association of Rhegmatogenous Retinal Detachment Incidence With Myopia Prevalence in the Netherlands

Abstract

IMPORTANCEThe incidence of rhegmatogenous retinal detachment (RRD) is partly determined by its risk factors, such as age, sex, cataract surgery, and myopia. Changes in the prevalence of these risk factors could change RRD incidence in the population. OBJECTIVE To determine whether the incidence of RRD in the Netherlands has changed over recent years and whether this change is associated with an altered prevalence of RRD risk factors. DESIGN, SETTING, AND PARTICIPANTSThis cohort study included data from all 14 vitreoretinal clinics in the Netherlands, as well as a large Dutch population-based cohort study. All patients who underwent surgical repair for a primary RRD in the Netherlands from January 1 to December 31, 2009, and January 1 to December 31, 2016, were analyzed, in addition to all participants in the population-based Rotterdam Study who were examined during these years. Analysis began February 2018 and ended November 2019.EXPOSURES RRD risk factors, including age, male sex, cataract extraction, and myopia.MAIN OUTCOMES AND MEASURES Age-specific RRD incidence rate in the Dutch population, as well as change in RRD incidence and risk factor prevalence between 2009 and 2016.RESULTS In 2016, 4447 persons (median [range] age, 61 [3-96] years) underwent surgery for a primary RRD within the Netherlands, resulting in an RRD incidence rate of 26.2 per 100 000 person-years (95% CI, 25.4-27.0). The overall RRD incidence rate had increased by 44% compared with similar data from 2009. The increase was observed in both phakic (1994 in 2009 to 2778 in 2016 [increase, 39%]) and pseudophakic eyes (1004 in 2009 to 1666 in 2016 [increase, 66%]), suggesting that cataract extraction could not solely account for the overall rise. Over the same period, the prevalence of mild, moderate, and severe myopia among persons aged 55 to 75 years had increased by 15.6% (881 of 4561 [19.3%] vs 826 of 3698 [22.3%]), 20.3% (440 of 4561 [9.6%] vs 429 of 3698 [11.6%]), and 26.9% (104 of 4561 [2.3%] vs 107 of 3698 [2.9%]), respectively, within the population-based Rotterdam Study.CONCLUSIONS AND RELEVANCE In this study, an increase was observed in primary RRD incidence in the Netherlands over a 7-year period, which could not be explained by a different age distribution or cataract surgical rate. A simultaneous myopic shift in the Dutch population may be associated, warranting further population-based studies on RRD incidence and myopia prevalence.

Differential Distributions of Myopia Severity in Younger and Older Individuals with Rhegmatogenous Retinal Detachment

“…Findings from this study were very consistent with a previous study by Kim and associates from a Korean population showing that the majority of younger individuals with RRD had high myopia compared with older individuals, determined by axial length of >26 mm. 3 Myopia has been strongly associated with RRD 1,4 due to the fact that myopic individuals, particularly those with high myopia, are more likely to have a thinner retina 5 and are prone to experience premature vitreous liquefactions causing posterior vitreous detachment. 6 Taken together, those factors are key for the development of retinal tear and subsequent RRD.…”

“…Myopia has been strongly associated with RRD 1 , 4 due to the fact that myopic individuals, particularly those with high myopia, are more likely to have a thinner retina 5 and are prone to experience premature vitreous liquefactions causing posterior vitreous detachment. 6 Taken together, those factors are key for the development of retinal tear and subsequent RRD.…”

“…A recently published observation from the Netherlands showed an interesting incidence of rhegmatogenous retinal detachment (RRD) which mimicked the increasing prevalence of myopia. 1 This raised a further question whether it is conceivable to link between those two – increasing myopia causing increasing RRD – since individual data on severity of myopia and incident RRD are still lacking. 2 In line with this, we aimed to report the differential distribution of the severity of myopia in younger and older individuals with RRD.…”

Increasing frequency of hospital admissions for retinal detachment and vitreo-retinal surgery in England 2000–2018

“…An eye with a refractive error of more than −3 dioptres has a tenfold increased risk of RD compared to an emmetropic eye [ 9 ]. An analysis of the incidence of RRD in the Dutch consortium of hospitals to study a putative association of increasing RRD rates with myopia found it likely that higher rates of myopia in the population may explain part of the increase [ 16 ]. The increase in the number of performed cataract operations can be partly attributed to population aging, and hence a higher prevalence of cataracts.…”

Increasing trend in rhegmatogenous retinal detachment in Korea from 2004 to 2015

“…On the other hand, Nielsen et al reported that the incidence of RRD is mainly increasing in the Caucasian population using the Danish National Patient Registry data from 2000 to 2016 [ 12 ] and suggested that the observed increase is primarily driven by male patients aged 50 years or older. Although not a nationwide cohort study, Redmer et al also reported an increase in primary RRD incidence in the Dutch population with a simultaneous myopic shift [ 13 ].…”