Primary rhegmatogenous retinal detachment: risk factors
for macular involvement
Thomas J. Wolfensberger
Received: 30 August 2017 /Revised: 11 December 2017 /Accepted: 14 December 2017 / Published online: 28 December 2017
Springer-Verlag GmbH Germany, part of Springer Nature 2017
Purpose Rhegmatogenous retinal detachment (RD) has diagnostically been divided into macula-OFF or macula-ON. The aim of
this study was to describe the demographics and primary outcome of patients with RD following surgery with respect to the
macular status, and to determine risk factors for macular involvement.
Methods This prospective, observational, mono-centric cohort study was conducted at the Jules-Gonin Eye Hospital, from
February 2015 until March 2017. The study included 194 eligible patients with primary RD. All patients underwent surgical
treatment after baseline clinical examination. The dataset was analyzed using descriptive and analytic statistics.
Results A total of 52.6% (102/194) of patients presented with macula-OFF RD. Mean age was 63.9 ± 12.0 vs. 59.7 ± 11.2 years
in the OFF and ON group, respectively. There were 129 men (66.5%) and 65 (33.5%) women, and there were significantly more
right eyes affected [right vs. left eyes 123 (63.4%) vs. 71 (36.6%), p = 0.000]. Significantly more myopes (<−3D) presented with
a macula-ON RD (p = 0.04). There were more phakic patients in the cohort (55.7%), and phakic eyes were more likely to present
with macula-ON RD (p = 0.01). Multivariate modeling showed that pseudophakic lens status and eyes with axial length less than
25 mm (p = 0.06) are independent predictive factors for macula-OFF RD (p = 0.02), whereas sex and laterality were not risk
factors for macular involvement.
Conclusion Pseudophakic lens status and axial length < 25 mm are independent predictive factors for macula-OFF RD. While
pseudophakic lens status is a recognized risk factor for RD, shorter axial length has not been previously identified as a risk factor
for the macula-OFF RD.
Keywords Retinal detachment
The incidence of rhegmatogenous retinal detachment (RD) is
estimated to be 1/10,000 persons per year, increasing to about
3.5 to 5.8% for recurrences within the first year after a primary
RD and 10% within 4 years for the second eye . The macula-
ON and macula-OFF statuses in RD are considered different
stages; however, the risk factors for progression to macular
involvement in RD have not been extensively studied. The
majority of studies comparing RD based on macular status used
retrospectively collected data, which limits the available infor-
mation, especially regarding risk and retinal features. The aim
of this study was to describe the demographics of RD patients
and primary outcomes after surgery with respect to macular
status in a cohort of consecutive prospectively enrolled patients.
The study followed the tenets of the Declaration of Helsinki
and was approved by the Ethical Committee of Canton Vaud,
Switzerland (protocol no. 483/14).
* Jelena Potic
Thomas J. Wolfensberger
Department of Ophthalmology, University of Lausanne, Jules-Gonin
Eye Hospital, Fondation Asile des Aveugles, Avenue de France 15,
1002 Lausanne, Vaud, Switzerland
Clinic for Eye Diseases, Clinical Center of Serbia, School of
Medicine, University of Belgrade, Beograd, Serbia
Graefe's Archive for Clinical and Experimental Ophthalmology (2018) 256:489–494