Study On The Risk Factors Of Rhegmatogenous Retinal Detachment

Background: Rhegmatogenous retinal detachment (RRD) is one of the important blinding diseases. Its onset is quick, and if the treatment didn't been carried out in time, the patients will lose vision soon. The prevention of the diseas is very important,while based on knowing the influence of the risk factors on RRD firstly, and determining the efficacy of the prophylactic therapy secondly. Several major risk factors have been described that significantly influence the risk of RRD development, including age, cataract surgery, high myopia, blunt trauma and family history. Mean while, we study the fundus oculi process among the fellow eyes of RRD, and to investigate result of prophylactic treatment.Part One: Study the risk factors of RRDPurpose To investigate the risk factors of RRD, including age,myopia, blunt trauma, cataract extraction and family history of RRD. Method 1∶1 case control study was performed on 150cases with RRD and 150 without RRD (control group). The criteria of controls included: without the history of RRD and a good match with cases in age, sex and residential area. The influence of the risk factors for rhegmatogenous retinal detachment and the odds ratio (ORs) and population attributed risk proportion (PARPs) of the risk factors were calculated and tested. Results There was a high incidence of RRD in persons between 40 and 59 year old. These patients included 72 men and 78 women.55.33% of RRD patients were high myopia.When compared with the contrast group, the incidence of RRD raised significantly With the degree of myopia increasing(χ2=23.44,P<0.01). Bilateral RRD happened in 16 patients(10.67%),and was common under 40 year old(75%). 14 patients (9.33%) had blunt trauma history before the RRD onset, and most of these patients are male with age from 20 to 39 year old. The incidence of RRD relatives of these patients was 1.17%. 8% patients who had undergone cataract surgery before the RRD oneset,and most of these patients were men older than 50.The ORs of blunt trauma, myopia, cataract extraction and family history of RRD were 6.56 (95%CI, 2.64~25.31, P<0.01), 5.36(95%CI,2.28~6.68,P<0.01) and 20 (95%CI,3.34~99,P<0.01), respectively. The PARPs of blunt trauma, myopia and cataract extraction were 12%, 62% and 9.4%, respectively. Conclusion Myopia, age,blunt trauma, and cataract extraction are risk factors for RRD,and family history of RRD is not found to be related to RRD.Part Two:Investigating the fellow eye in patients with RRD and prophylactic treatmentpurpose To investigate the pathological changes of ocular fundus of fellow eyes and to treat prophylactic. Methods A total of 136 patients with RRD were observed. The fundus oculi of the fellow eyes of RRD were examined with three-mirror contact lens after mydriasis. And the severe process(including newly RRD, dry- holes , lattice degeneration , cystoid degeneration ) were prophylactic treated with argon laser photocoagulation alone or assisted with buckling scleral . And with a follow-up for 3 months, the incidence rate and preventive treatment of their fellow eye were analyzed. Results Among the 136 case, retinal abnormity occurred in 86 cases (63.24% ) , including 3 cases with RRD, 11 cases with dry-hole, 22 cases with single lattice degeneration, 8 cases with lattic degeneration with dry-hole. The incidence of dry-hole that happened in the patients with high myopia was obviously higher than that in the cases without high myopia(χ2=3.91,P﹤0.05).The incidence of lattice degeneration and cystoid degeneration raised with the myopia degree increasing(P﹤0.05). After intervention with argon laser photocoagulation, the sighted acuity of the fellow eyes with retinal degeneration had not changed;and one newly RRD exented below 2PD reattachment successful finally,and the sighted acuity preserved as before.Another case of newly RRDs after undergone argon laser photocoagulation assisted buckling scleral, achieved succeed anatomic reattachment and the sighted acuity as before too. Conclusion The retinopathy of the fellow eyes is related with high myopia, and prophylactic therapeutic efficacy is reliable.