Macular hole as a risk factor of choroidal detachment in rhegmatogenous retinal detachment.
OBJECTIVE
Choroidal detachment (CD) associated with rhegmatogenous retinal detachment (RRD) is a rare, but serious condition, which makes the prognosis worse. Previously reported risk factors for CD in RRD patients include high myopia, aphakia, pseudophakia, and advanced age. However, macular hole has not been discussed as an important factor in increasing the risk of CD in RRD patients. The purpose of this study was to evaluate macular hole as a risk factor for CD in eyes evidencing RRD.


METHODS
The medical records of 480 patients with primary RRD were reviewed. We compared the CD incidence among the RRD patients in accordance with the presence or absence of macular holes. The relationship between gender, age, presence of systemic disease, refractive errors, lens status, intraocular pressure and the development of CD were also analyzed.


RESULTS
The incidence (4/21 eyes, 19.0%) of CD in the RRD with macular hole was significantly higher than that (7/459 eyes, 1.5%) observed in the RRD without macular hole (p=0.010). The preoperative intraocular pressure (mean+/-SD; 2.5+/-1.3 mmHg) in the RRD with CD and macular hole was significantly lower than that (7.4+/-4.4 mmHg) observed in the cases of RRD with CD without macular hole (p=0.035). The eyes complicated by CD evidenced a higher prevalence of diabetes mellitus (p=0.024) than was observed in the eyes without CD.


CONCLUSIONS
The retinal detachment combined with macular hole creates a predisposition toward the development of profound hypotony and CD.
Kang
Jae Hoon
JH
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Park
Kyung Ah
KA
Shin
Woo Jae
WJ
Kang
Se Woong
SW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015862:Choroid Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D015814:Ocular Hypotension / Q000209:etiology; D012163:Retinal Detachment / Q000150:complications*; D012167:Retinal Perforations / Q000150:complications*; D012307:Risk Factors; D012422:Rupture, Spontaneous