The Impact of Travel Distance on Rhegmatogenous Retinal Detachment Presentation and Outcomes

Abstract

Background and Objective: Rhegmatogenous retinal detachment (RRD) requires urgent surgical intervention. The effect of travel distance on RRD outcomes is unclear. Patients and Methods: This retrospective cohort study included 642 patients who underwent RRD repair at Cole Eye Institute from 2012 to 2020. Google Maps was used to calculate the travel distance in miles from the residential zip code to the presenting and surgery location addresses. Multivariable logistic and bivariate linear regressions were used to compare macula-off status and best-corrected visual acuity (BCVA) in ETDRS letters at presentation and at 6-month follow-up, with patient travel distance divided into < 25 miles, 25 to 50 miles, and > 50 miles. Results: Four hundred sixty-two patients were examined in the final cohort. The retinal reattachment rate was 94.3% for less than 25 miles, 96.3% for 25 to 50 miles, and 95.9% for greater than 50 miles ( P = 0.63). In multivariable analysis, distance to presenting location was not associated with macula-off status ( P = 0.69) or BCVA at follow-up ( P = 0.27). Oneway analysis of distance and time from presentation to surgery in days revealed that distance to surgical site was associated with longer time to surgery ( P = 0.003). Subset analysis of patients with income less than $25,520 ( n = 18) revealed greater distance to presenting and surgical location was associated with longer time to surgery ( P < .0001), but was not associated with BCVA at follow-up ( P = 0.53). Conclusions: This data suggests that patients who live further from the hospital achieve equivalent outcomes from RRD repair, despite delays in surgery. [ Ophthalmic Surg Lasers Imaging Retina 2022;53:666–672.]

When to repair a retinal detachment?

“…• All pseudophakic patients and patients with incomplete posterior vitreous detachment should be educated about the possibility and symptoms of retinal detachment so that the delay from the beginning of symptoms to diagnosis is short. • Physicians should be aware that socioeconomic disparities can negatively impact the prognosis of patients with RRD [27][28] .…”