title: The predisposing pathology and clinical characteristics in the Scottish retinal detachment study.
abstract: OBJECTIVE
  To describe the predisposing pathology and clinical features of all incident cases of rhegmatogenous retinal detachment (RRD) recruited in Scotland during a 2-year period.
  
  
  METHODS
  Prospective surveillance study of incident cases of RRD.
  
  
  METHODS
  All incident cases of RRD recruited as part of the Scottish Retinal Detachment Study.
  
  
  METHODS
  During a 2-year period, we coordinated a comprehensive system in which every case of primary RRD presenting to 1 of 6 vitreoretinal surgical sites in Scotland was examined and approached for study inclusion.
  
  
  METHODS
  Rhegmatogenous retinal detachment incidence, predisposing features, and clinical characteristics.
  
  
  RESULTS
  A total of 1202 cases were recruited. Detailed clinical information was available on 1130 (94%) of cases. By causative break, the proportions of RRD were horseshoe tear (HST) associated with posterior vitreous detachment (PVD) in 86.2%, giant retinal tear (GRT) and PVD in 1.3%, non-PVD round hole (RH) in 4.9%, retinal dialysis in 5.9%, and retinoschisis RRD in 1.6%. One in 10 cases reported significant ocular trauma. One in 5 cases were pseudophakic. Round hole RRD more frequently presented with multiple retinal breaks compared with HST RRD (67.8% vs. 48.7%; P = 0.003). In PVD-associated RRD, 56.1% (95% confidence interval [CI], 53.8-58.3) of breaks were identified in the superotemporal retina. In non-PVD RRD, 54.6% (95% CI, 47.9-61.1) of breaks were inferotemporal, followed by superotemporal in 34.9% (95% CI, 28.7-41.5). Lattice degeneration was present in 18.7% of affected eyes and more common in RH RRD (35.7%) than in HST RRD (19.3%) (P = 0.003). Seven percent reported an affected first-degree relative, and these cases were significantly more myopic than nonfamilial cases.
  
  
  CONCLUSIONS
  More than 85% of RRD cases are associated with PVD and related tractional tears. Non-PVD RH RRD occurred in younger and more myopic individuals. The majority of cases are caused by more than 1 retinal break, and the macula is affected in more than 50% at presentation. Ocular trauma, previous cataract surgery, family history, and lattice degeneration are important predisposing features.
authors.affiliation: Department of Public Health Sciences, University of Edinburgh, Teviot Place, UK. mitryd@gmail.com
authors.forename: Danny
authors.initials: D
authors.lastname: Mitry
authors.forename: Jaswinder
authors.initials: J
authors.lastname: Singh
authors.forename: David
authors.initials: D
authors.lastname: Yorston
authors.forename: M A Rehman
authors.initials: MA
authors.lastname: Siddiqui
authors.forename: Alan
authors.initials: A
authors.lastname: Wright
authors.forename: Brian W
authors.initials: BW
authors.lastname: Fleck
authors.forename: Harry
authors.initials: H
authors.lastname: Campbell
authors.forename: David G
authors.initials: DG
authors.lastname: Charteris
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005131:Eye Injuries / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D019591:Pseudophakia / Q000453:epidemiology; D012030:Refractive Errors / Q000150:complications; D012162:Retinal Degeneration / Q000150:complications; D012163:Retinal Detachment / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics / Q000503:physiopathology*; D012167:Retinal Perforations / Q000150:complications* / Q000235:genetics; D041441:Retinoschisis / Q000150:complications; D012606:Scotland / Q000453:epidemiology; D017678:Sex Distribution; D018630:Vitreoretinopathy, Proliferative / Q000150:complications; D020255:Vitreous Detachment / Q000150:complications; D055815:Young Adult