Overview of Scottish RD survey 10 years on

1. The Scottish RD
survey 10 years on
Article Review
Dr. Zaid Azhar
PGY-1 Ophthalmology
Shifa International Hospital, Islamabad

2. The Scottish RD survey 10 years on: the
increasing incidence
of retinal detachments [2022]
Authors:
• Dr. Mariam El-Abiary
• Dr. Fatemah Shams
• Dr. Colin Goudie
• Dr. David Yorston

3. Background
• The Scottish RD Survey was carried out between 2007 and
2009, published in 2010 and updated in 2012.
• Data from across six vireo-retinal surgical sites (Ayr,
Glasgow, Edinburgh, Dundee, Aberdeen and Inverness)
was compiled.

4. Background
 Aims of 2012’s Scottish RD Review were:
• To establish a complete case register of new cases of RRD
in the Scottish population over a 2 year period.
• To provide data to inform the planning of vitreoretinal
surgical services in Scotland.
• To conduct a genome-wide association study of RRD to
identify novel common genetic variants associated with
risk of RRD.
 The 2022 Scottish RD review is a follow up to the 2012
study and specifically address increasing incidence of RRD.

5. Retinal
Detachment
• Retinal Detachment (RD) is a sight threatening condition
which requires prompt surgical management in a
specialist centre.
• It is caused by a separation of the neurosensory retina
(NSR) from the underlying retinal pigment epithelium
and the accumulation of fluid within this potential space.
• Types of retinal detachment include rhegmatogenous,
exudative, tractional, combined tractional-
rhegmatogenous, and macular hole–associated
detachment.
• Rhegmatogenous retinal detachment is the most common
type of retinal detachment.

6. Rhegmatogenous Retinal
Detachment (RRD)
• The pathogenesis of RRD
involves vitreoretinal
tractional forces that result
in a full-thickness retinal
break. Liquefied vitreous
gel then enters the
subretinal space through
the break, causing
separation of the neu-
rosensory retina from the
underlying retinal pigment
epithelium.

7. Aims of 2022 Scottish RD
review study
• To demonstrate change in incidence of RRD
amongst Scottish population since the
2012 survey.
• To demonstrate age and sex distribution of
RRD.
• To demonstrate some factors that might
influence new incidence in RRD.

8. Materials and Methods
• Study type: prospective population-based epidemiology
study
• Study location: All sixteen VR surgeons based in six VR
units across Scotland. All RRD cases referred here.
• Data collection: Study centres were provided with blank
spreadsheets to collect anonymous data between 12th
2019 and 11th August 2020 and were required to submit
on monthly basis.

9. Inclusion, Exclusion
criteria
Inclusion criteria
• RRD classification in surgical terms
as any break in the neurosensory
retina with surrounding sub-retinal
fluid requiring intervention more
than cryotherapy and/or laser
treatment to reattach or stabilise
the retina.
• Patients are also included if they
present with a RRD which was not
immediately managed.
• Blunt traumatic cases of RRD.
Exclusion Criteria
• Recurrent RRD.
• RRD associated with penetrating
injury
• RRD post previous vitrectomy
• Combined tractional and
rhegmatogenous RD

10. Data Collected
Demographi
c
• Age
• Sex
General
vision
• VA
• Eye laterality
RD
features
• Clock Hours
break
• Retinal break
type
Lens,
Macula
Status
• Phakic or
Pseudophakic
• Macula Status
Surgery
Performed
• Type
1 2 3 4 5

11. Results

12. Data Analysis
• Age-specific incidence was calculated by
dividing the frequency of RRDs by the
population of the corresponding age group at
that time.
• Data was collated in Microsoft Excel
• Statistical analysis performed in MedCalc®
Statistical Software.
• The χ2 test was used to compare the
incidence rates between both studies and a p
value of <0.5 was considered significant.

13. Incidence
• 875 RRDs recorded, which gives an incidence of
16.02/100,000/year.
• The 2012 study reported an RRD incidence of 12.05/100,000/year.
• Hence incidence of RRD shows increase of 32%.
• Compared to the previous study, this represents an incidence ratio
of 1:1.315

14. Gender wise distribution
Males:
• Percentage incidence increased from 61% to 63 %.
• The total incidence has increased from 14.75 to 20.39 in males
Females:
• Percentage incidence decreased from 39% to 37%.
• The total incidence has increased from 8.74 to 11.5 in females.

15. Age wise distribution
• The highest percentage of retinal detachments is in the 50–
59 age group.
• The greatest increases were seen in:
1. males aged 50–59 and 60–69
2. females aged 40–49 and 50–59

16. Age, sex wise distribution

17. Lens status distribution
• The proportion of pseudophakic RRDs in this study is 29.4% as
compared to the 21.6% in the previous study.
• This represents a 28% increase.

18. Macula status distribution
Percentage of macula-off RRDs remains stable at 58% (495/
854) as compared to the previous study.

19. Strengths and Weaknesses
Strengths
• Prospective nature – can
add to study.
• Inclusion of all incident
RRDs in a well-defined
and large population.
Weaknesses
• Limited clinical data
regarding refractive
status – axial length,
refractive error, hence
cannot draw association.

20. Conclusion
• There is a statistically significant increase in
the incidence of rhegmatogenous retinal
detachments in Scotland in the last 10 years.
• This trend should be considered when
planning for VR services in the future.

21. “
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