The effect of age on phenotype of primary rhegmatogenous retinal detachment

Background: To evaluate the influence of age on the clinical characteristics of primary rhegmatogenous retinal detachments (RRD). Methods: We conducted a retrospective review of a prospectively collected dataset. Data regarding adult patients (aged 16–100 years) who had undergone primary RRD repair, were extracted from two online databases. Baseline demographics, preoperative clinical characteristics and surgical management details were collected. Age-based groups (16–30, 30–39, 40–49, 50–59, 60–69, 70–79, ≥80) were compared using univariate analysis, with multivariate testing for interaction of age with sex, laterality and pseudophakia. Results: In total, 8,133 eyes were analysed, of which the majority (59%) were in the 50–69 age-range peaking at 60, with a male predominance (64%). Myopia was significantly more frequent in patients aged <50 years. The presence of posterior vitreous detachment increased up to 50 years, then remained >95%. Foveal involvement, grade C proliferative vitreoretinopathy, total RD and greater RD extent were more common and progressively increased after 60 years, with worsening visual acuity. Isolated superior RRDs became more prevalent with age reaching a plateau in the age-range 50–69, before reducing again; conversely, isolated inferior RRDs were commoner in those <30, with a minimum in the 70–79 age-range. The incidence of fellow-eye RRD decreased linearly with age. Conclusions: Age appeared a key variable in RRD phenotype influencing a wide range of RRD characteristics. The higher incidence of myopia, PVD absent and bilateral RRD in patients <40 years and the significant phenotypical differences in the under 40 and over 50 age-groups highlight that there are several discrete forms of RRD.