Characteristics of Bilateral Retinal Detachment

Abstract

Introduction: Rhegmatogenous retinal detachment (RD) is still a sight threatening and potentially blinding disease, especially if both eyes are affected. The purpose of this study is analysing the specific characteristics of bilateral rhegmatogenous retinal detachment (RD). Methods: The files of all 5791 consecutive eyes undergoing vitreoretinal surgery for uncomplicated RD in a single tertiary retinal centre between Jan 2005 und June 2021 were retrospectively reviewed. Results: 300 patients (600 eyes) had bilateral retinal detachment. Interval between initial and subsequent RD surgery was 2.6 ± 2.8 (mean ± SD, median 1.5) years. Symptoms were reported by the patients for 20 ± 75 (median 5) days before presentation in the initial eye and 12 ± 32 (median 4) days in the subsequent eye. 220 patients were male (73%), mean age at initial RD was 55 years. 183 (61%) of the initial RD eyes were phakic. In the initial eye more patients had a detached macula, worse visual acuity and more quadrants involved. Primary anatomic success rate was higher in the subsequent eye (90%) compared to the initial eye (83%). There was no difference in the reattachment rate of fellow eyes with primary failure in the first eye (91%) compared to those with primary success in the first eye (90%). There was a high symmetry between the eyes in terms of type of retinal break, number of breaks and presumed localization of the causative retinal break. Conclusion: Patients with bilateral RD were more common male and younger than the group of all RD patients. The proportion of pseudophakia was not different. The majority of fellow eye RD occurred within two years after the RD in the first eye. Second eye RD was less advanced and had a better anatomical repair rate. Despite their experience in the first eye and despite typical symptoms patients presented only after in mean 12 days with RD in the second eye. RD in the initial and the subsequent eye showed a high symmetry. The anatomic result in the first eye is not a predictor for the anatomic results in the subsequent eye.