Retinal Detachment in Southwest Ethiopia: A Hospital Based Prospective Study

Abstract

PurposeThe incidence of retinal detachment in Blacks is generally considered to be low though there are few supporting studies in Africa. This study, thus, aimed at describing the clinical profile of patients with retinal detachment in Southwest Ethiopia.MethodsA hospital-based study was done on all consecutive retinal detachment patients who presented to Jimma University Hospital over six months period. A semi-structured questionnaire was used to collect patients’ sociodemographic characteristics and clinical history. Comprehensive anterior and posterior segment eye examinations were done and risk factors were sought for. Statistical tests were considered significant if P < 0.05.ResultsA total of 94 eyes of 80 patients (1.5%) had retinal detachment (RD) and about 69% of patients were symptomatic for over a month before presentation. The mean age was 41.4 years (SD ±16.5). Fourteen patients (17.5%) had bilateral RD. At presentation, 61 eyes (64.9%) were blind from RD and 11 (13.8%) patients were bilaterally blind from RD. Rhegmatogenous RD was seen in 55 eyes (58.5%) and tractional RD in 22 eyes (23.4%). The most common risk factors were ocular trauma (32 eyes, 34.0%), myopia (23 eyes, 24.5%), posterior uveitis (13 eyes, 13.8%) and diabetic retinopathy (9 eyes, 9.6%). Most retinal breaks (25 eyes, 43.1%) were superotemporal and horse-shoe tear was the most common (19 eyes, 20.2%). Macula was off in 77 eyes (81.9%) and 38 eyes (69.1% of RRD eyes) had grade C proliferative vitreoretinopathy (PVR). Macular status was significantly associated with PVR (P=0.011), and duration of symptoms (RR=1.25, 95%CI: 1.059-1.475, P=0.040).ConclusionsA significant numbers of patients with ocular problem had retinal detachment, and nearly two third of the patients presented late. Trauma and myopia were the most important risk factors. People should be educated to improve their health seeking behavior and use eye safety precautions to prevent ocular trauma.

Outcomes of Vitrectomy in Pediatric Retinal Detachment with Proliferative Vitreoretinopathy

“…Late diagnosis in pediatric patients leads to more frequent macula-off status, with extensive multiple-quadrant RD and higher rates of PVR development. In our series, macula-off status was detected in 86% at presentation, similar to 80% [ 2 ] and 81.9% [ 14 ] reported by other investigators. On the contrary, in another study, lower rate (50%) of macula-off status was reported but still it was due to late diagnosis, as described by the authors [ 10 ].…”

“…On the contrary, in another study, lower rate (50%) of macula-off status was reported but still it was due to late diagnosis, as described by the authors [ 10 ]. In our research, PVR Grade C was noted in 100% of eyes at presentation and was higher than in other studies (70% [ 10 ] and 69.1% [ 14 ]). Higher rate of advanced PVR is probably associated to late diagnosis and in most cases posttraumatic changes in eyeball.…”

“…Soheilian et al also evaluated the clinical features and functional and anatomical outcomes after surgical intervention in pediatric rhegmatogenous RD and found that trauma and congenital developmental anomalies are leading etiologies in pediatric rhegmatogenous RD [ 12 ]. In many studies, myopia is indicated to be a common etiological factor of pediatric RD (18.1–38%) [ 2 , 13 , 14 ]. We also found a strong male predominance (79%) similar to another series [ 13 ].…”

Rhegmatogenous retinal detachment in uveitis

“…Serous RD typically occurs in Vogt-Koyanagi-Harada disease and may also be a complication of severe scleritis, while tractional RD often develops as a complication of vitritis or chorioretinitis scarring with retinal traction. Rhegmatogenous retinal detachment (RRD) seems to predominantly occur in patients with retinitis-associated posterior uveitis [ 2 ]. The prevalence of RRD among uveitis patients is reported as 3.1%, whereas the incidence of retinal detachment in the general Dutch population is around 18 per 100,000 [ 3 – 8 ].…”

Genetic analysis of axial length genes in high grade myopia from Indian population

“…It is most prevalent in Taiwan, Japan, China, Korea (east Asia), and Singapore (south east Asia) affecting ~ 60–80% of young adults ( Hsu et al, 2008 , Kim et al, 2013a , Lam et al, 2012 , Pan et al, 2013 , Sawada et al, 2008 , Yao et al, 2013 ). Long term myopia leads to irreversible eye problems which includes chorioretinal degeneration, retinal detachment, lattice degeneration ( Asaminew et al, 2013 , Koh et al, 2013 ), glaucoma ( Detry-Morel, 2011 ) etc. and hence poses a serious socio-economic problem.…”