The impact of sociodemographic factors on the presentation and outcomes of rhegmatogenous retinal detachment (RRD) in the United States have not been described. We analyzed the impact of these factors on the presenting fovea-on or off status of RRD, single operation anatomic success (SOAS) of repair, and post-operative visual acuity (VA).
Retrospective, single-center, cohort study.
Participants included 4,061 patients from Wills Eye Hospital/Mid Atlantic Retina from February 2015 to February 2020.
Sociodemographic factors including age, gender, race, and regional mean household income (MHI) as determined by zip code were recorded. VA at baseline and 12 months post-RRD repair was recorded. Multiple regression analysis was used to evaluate the relationship between sociodemographic factors to fovea-on or off presentation of RRD, SOAS and 12 month VA.
Foveal attachment at presentation of RRD, SOAS, and 12 month VA.
Older age (odds ratio [OR] = 1.34 per decade, 95% confidence interval [CI] 1.27-1.41, p < 0.001), male gender (OR = 1.27, 95% CI 1.11-1.45, p < 0.001), non-Caucasian race (OR = 2.41, 95% CI 1.92-3.03, p < 0.001), and lower MHI (OR = 0.94 per $10,000, 95% CI 0.91-0.98, p = 0.005) were independent risk factors for fovea-off presentation of RD. The need for re-operation to repair RD within 90 days was independently associated with fovea-off presentation (OR = 1.47, 95% CI 1.24-1.74, p < 0.001) and non-Caucasian race (OR = 1.72, 95% CI 1.27-2.39, p < 0.001). Finally, 12 month post-operative VA was worse in patients who were fovea-off (p < 0.001), older (p = 0.041), male (p = 0.038) and non-Caucasian (p = 0.007), but was not related to MHI (p = 0.24).
These findings reveal associations between sociodemographic factors and the presentation and outcomes of RRD. Physicians should be aware that socioeconomic disparities can negatively impact the prognosis of patients with RRD. Further study confirming these findings, as well as efforts to mitigate their effects, are warranted and will be of interest to the greater ophthalmology community.
Copyright © 2020. Published by Elsevier Inc.