Sex Differences in the Repair of Retinal Detachments in the United States

Callaway, Natalia F.; Vail, Daniel; Al-Moujahed, Ahmad; Ludwig, Cassie A.; Ji, Marco H.; Mahajan, Vinit B.; Pershing, Suzann; Moshfeghi, Darius M.

doi:10.1016/j.ajo.2020.06.039

Cited by 17 publications

(13 citation statements)

References 35 publications

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“…Ung et al showed that the mean age lies between 25 and 35 years and scleral buckling procedures remained highly effective in this selected group of patient [6]. Interestingly, this type of RRD was found predominantly in females [6][7][8]. In the present study, we also found a trend (not statistically significant) of female predominance (55%) in the age group 20-39 years of age.…”

Section: Discussionsupporting

confidence: 65%

Rhegmatogenous retinal detachment repair—does age, sex, and lens status make a difference?

Radeck

Helbig

Maerker

et al. 2022

Graefes Arch Clin Exp Ophthalmol

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Purpose To analyze the correlation between lens status, age, and sex in the epidemiology and success rates of rhegmatogenous retinal detachment (RRD) surgery. Methods The files of all consecutive patients undergoing vitreoretinal surgery for uncomplicated RRD between Jan 2005 und Dec 2020 were retrospectively reviewed. Successful outcome was defined as no retinal redetachment occurring within 3 months after surgery. Results 5502 eyes with uncomplicated primary RRD were included. Mean age of the patients was 61.1 years (± 13.6 SD). In the age group over 40 years, a male predominance was found. The percentage of pseudophakic RRD increased from 25 to 40% during the 15 years observation period. In the age group 50 to 69 years, patients with pseudophakic detachments were male in 786 out of 1079 cases (72.9%). In the same age group, 1285 of 2110 (60.9%) patients with phakic RRD were male. Overall, primary success rate after one procedure was 91.2% (5018 of 5502). In the phakic eyes, the primary success rate was higher in those eyes that underwent combined phacovitrectomy (93.0%), compared to those without simultaneous cataract surgery (88.7%; p = 0.002). Conclusion The ratio of male and female patients with RRD varies between age groups. The proportion of pseudophakic RRD has increased within 15 years. The male predominance in RRD is stronger in pseudophakic than in phakic eyes. In phakic eyes with RRD, a combined phacovitrectomy yielded better anatomical results.

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Section: Discussionsupporting

confidence: 65%

Rhegmatogenous retinal detachment repair—does age, sex, and lens status make a difference?

Radeck

Helbig

Maerker

et al. 2022

Graefes Arch Clin Exp Ophthalmol

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“…17,18 Although female sex has not been reliably associated with more favorable anatomic outcomes in RRD, recent evidence has pointed to possible differences in time to repair between selfreported male and self-reported female individuals. 19 The patients in this cohort had favorable visual outcomes across both the SOS and SOF groups. It has been shown in retrospective studies 20 as well as PIVOT 2 that even eyes that fail initial repair with PR may have good visual outcomes.…”

Section: Discussionmentioning

confidence: 72%

Clinical Outcomes of Rhegmatogenous Retinal Detachment Treated With Pneumatic Retinopexy

Yannuzzi

Fujino

et al. 2021

JAMA Ophthalmol

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IMPORTANCE Pneumatic retinopexy (PR) is the only clinic-based method of rhegmatogenous retinal detachment (RRD) repair. Registry-acquired clinical practice setting outcomes data with this procedure have not yet been reported. OBJECTIVETo describe the clinical outcomes associated with RRD treated primarily with PR. DESIGN, SETTING, AND PARTICIPANTSIn this retrospective cohort study, data from patients 19 years and older with noncomplex RRD treated at academic and private ophthalmology practices participating in the American Academy of Ophthalmology IRIS Registry (Intelligent Research in Sight) were analyzed. Data were collected from January 1, 2013, to December 31, 2019, and data were analyzed from January to December 2020.EXPOSURES Data from the IRIS Registry were queried for eyes that underwent PR for noncomplex RRD and had at least 3 months of follow-up. Cases were identified by a combination of diagnosis code for RRD and a Current Procedural Terminology code for PR. MAIN OUTCOMES AND MEASURESThe number of eyes that achieved single-operation success (SOS), defined as retinal reattachment without a subsequent retinal detachment surgery or repeated PR. RESULTSOf 9553 included patients, 5827 (61.0%) were male, and the mean (SD) age was 62 (10) years. A total of 9659 eyes were identified. SOS was achieved in 6613 eyes (68.5%). Best-corrected visual acuity significantly differed 9 to 12 months after treatment between the SOS group, with a mean of 0.24 logMAR (95% CI, 0.23-0.25; approximate Snellen equivalent, 20/35), and the single-operation failure group, with a mean of 0.43 logMAR (95% CI, 0.40-0.46; approximate Snellen equivalent, 20/54). Among all patients, the mean time to maximal visual recovery was 268 days (95% CI, 260-276). Endophthalmitis was observed in 3 eyes (0.03%). SOS was associated with female sex (odds ratio, 1.51; 95% CI, 1.38-1.65), while current smoking status was associated single-operation failure (odds ratio, 0.78; 95% CI, 0.68-0.91). CONCLUSIONS AND RELEVANCEIn this registry-based study, which encompasses a large number of eyes drawn from multiple, heterogenous electronic health record systems, SOS was achieved in 68.5% of eyes with noncomplex RRD treated by primary PR. It is unknown how these outcomes would have compared with other methods of RRD repair in this cohort.

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“…Gerstenberger et al found higher incidence rates of rhegmatogenous RD in males in a population-based cohort study (OR = 4.16) [ 13 ]. Furthermore, the published literature has also identified higher rates of reoperation in males than females; Callaway et al found that women were less likely than men to undergo reoperation after primary PR (OR 0.7, 95% CI 0.62, 0.79, p < 001) [ 31 ]. The reason underlying these results could be due to biological factors, such as abnormal adhesions in the vitreoretinal interface and longer axial lengths seen in males [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the published literature has also identified higher rates of reoperation in males than females; Callaway et al found that women were less likely than men to undergo reoperation after primary PR (OR 0.7, 95% CI 0.62, 0.79, p < 001) [ 31 ]. The reason underlying these results could be due to biological factors, such as abnormal adhesions in the vitreoretinal interface and longer axial lengths seen in males [ 31 ]. Additionally, behaviour differences between sexes could interfere with adherence to postoperative positioning [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Incidence and Risk Factors Affecting the Recurrence of Primary Retinal Detachment in a Tertiary Hospital in Spain

Irigoyen

Goikoetxea-Zubeldia

Sanchez-Molina

et al. 2022

JCM

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(1) Objective: To determine the incidence, visual outcomes and risk factors associated with the recurrence of primary retinal detachment (RD) in a tertiary hospital. (2) Methods: A retrospective observational study was conducted, and data were collected on all eyes diagnosed with primary RD between January 2017 and December 2020. A detailed database was generated with data on anatomic and visual outcomes, and surgical technique information, for all the cases. (3) Results: 570 eyes with primary RD were included. Mean annual incidence of primary RD was 21.8 cases per 100,000 inhabitants. Mean follow-up time was 465 (±410.5) days. Mean time to redetachment was 114.4 (±215.8) days, with the median being 35 days. Statistically significant variables related to a higher risk of recurrence were: male sex (p = 0.04), type of tamponade (p = 0.01), surgeon (p = 0.035), inferonasal (p = 0.002) and inferotemporal (p = 0.032) involvement, complex RD (p < 0.001) and ocular comorbidity (p < 0.001). More satisfactory final visual acuity (VA) in patients not suffering redetachment was associated with shorter duration of central vision loss. (4) Conclusions: Sex, type of tamponade, inferior detachment, RD complexity, surgeon and ocular comorbidity were identified as prognostic factors for recurrence. Worse final postoperative VA was found in patients referring central vision loss for more than 4 days before surgery.

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Sex Differences in the Repair of Retinal Detachments in the United States

Cited by 17 publications

References 35 publications

Rhegmatogenous retinal detachment repair—does age, sex, and lens status make a difference?

Rhegmatogenous retinal detachment repair—does age, sex, and lens status make a difference?

Clinical Outcomes of Rhegmatogenous Retinal Detachment Treated With Pneumatic Retinopexy

Incidence and Risk Factors Affecting the Recurrence of Primary Retinal Detachment in a Tertiary Hospital in Spain

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