Korean J Ophthalmol.  2008 Jun;22(2):100-103. 10.3341/kjo.2008.22.2.100.

Macular Hole as a Risk Factor of Choroidal Detachment in Rhegmatogenous Retinal Detachment

Affiliations
  • 1Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. swkang@smc.samsung.co.kr

Abstract

PURPOSE: Choroidal detachment (CD) associated with rhegmatogenous retinal detachment (RRD) is a rare, but serious condition, which makes the prognosis worse. Previously reported risk factors for CD in RRD patients include high myopia, aphakia, pseudophakia, and advanced age. However, macular hole has not been discussed as an important factor in increasing the risk of CD in RRD patients. The purpose of this study was to evaluate macular hole as a risk factor for CD in eyes evidencing RRD. METHODS: The medical records of 480 patients with primary RRD were reviewed. We compared the CD incidence among the RRD patients in accordance with the presence or absence of macular holes. The relationship between gender, age, presence of systemic disease, refractive errors, lens status, intraocular pressure and the development of CD were also analyzed. RESULTS: The incidence (4/21 eyes, 19.0%) of CD in the RRD with macular hole was significantly higher than that (7/459 eyes, 1.5%) observed in the RRD without macular hole (p=0.010). The preoperative intraocular pressure (mean+/-SD; 2.5+/-1.3 mmHg) in the RRD with CD and macular hole was significantly lower than that (7.4+/-4.4 mmHg) observed in the cases of RRD with CD without macular hole (p=0.035). The eyes complicated by CD evidenced a higher prevalence of diabetes mellitus (p=0.024) than was observed in the eyes without CD. CONCLUSIONS: The retinal detachment combined with macular hole creates a predisposition toward the development of profound hypotony and CD.

Keyword

Choroidal detachment; Macular hole; Retinal detachment

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Choroid Diseases/*etiology
Female
Humans
Incidence
Intraocular Pressure
Male
Middle Aged
Ocular Hypotension/etiology
Retinal Detachment/*complications
Retinal Perforations/*complications
Risk Factors
Rupture, Spontaneous

Reference

1. Gottlieb F. Combined choroidal and retinal detachment. Arch Ophthalmol. 1972. 88:481–486.
2. Seelenfreund MH, Kraushar MF, Schepens CL, Freilich DB. Choroidal detachment associated with primary retinal detachment. Arch Ophthalmol. 1974. 91:254–258.
3. Sharma T, Challa JK, Ravishankar KV, Murugesan R. Scleral buckling for retinal detachment. Predictors for anatomic failure. Retina. 1994. 14:338–343.
4. Kang SW, Choi MY. Clinical evaluation of choroidal detachment associated with rhegmatogenous retinal detachment. J Korean Ophthalmol Soc. 1995. 36:2172–2180.
5. Rahman N, Harris GS. Choroidal detachment associated with retinal detachment as a presenting finding. Can J Ophthalmol. 1992. 27:245–248.
6. Sharma T, Gopal L, Badrinath SS. Primary vitrectomy for rhegmatogenous retinal detachment associated with choroidal detachment. Ophthalmology. 1998. 105:2282–2285.
7. Yang CM. Pars plana vitrectomy in the treatment of combined rhegmatogenous retinal detachment and choroidal detachment in aphakic or pseudophakic patients. Ophthalmic Surg Lasers. 1997. 28:288–293.
8. Poole TA, Sudarsky RD. Suprachoroidal implantation for the treatment of retinal detachment. Ophthalmology. 1986. 93:1408–1412.
9. Packer AJ, Maggiano JM, Aaberg TM, et al. Serous choroidal detachment after retinal detachment surgery. Arch Ophthalmol. 1983. 101:1221–1224.
10. Campochiaro PA. Pathogenic mechanisms in proliferative vitreoretinopathy. Arch Ophthalmol. 1997. 115:237–241.
11. Campochiaro PA, Jerdan JA, Glaser BM. Serum contains chemoattractants for human retinal pigment epithelial cells. Arch Ophthalmol. 1984. 102:1830–1833.
12. Nagasaki H, Ideta H, Uemura A, et al. Comparative study of clinical factors that predispose patients to proliferative vitreoretinopathy in aphakia. Retina. 1991. 11:204–207.
13. Swan KC, Christensen L, Weisel JT. Choroidal detachment in the surgical treatment of retinal separation. AMA Arch Ophthalmol. 1956. 55:240–245.
14. Jarrett WH 2nd. Rhematogenous retinal detachment complicated by severe intraocular inflammation, hypotony, and choroidal detachment. Trans Am Ophthalmol Soc. 1981. 79:664–683.
15. Ghoraba HH. Primary vitrectomy for the management of rhegmatogenous retinal detachment associated with choroidal detachment. Graefes Arch Clin Exp Ophthalmol. 2001. 239:733–736.
16. Loo A, Fitt AW, Ramchandani M, Kirkby GR. Pars plana vitrectomy with silicone oil in the management of combined rhegmatogenous retinal and choroidal detachment. Eye. 2001. 15:612–615.
17. Sharma T, Gopal L, Reddy RK, et al. Primary vitrectomy for combined rhegmatogenous retinal detachment and choroidal detachment with or without oral corticosteroids: a pilot study. Retina. 2005. 25:152–157.
18. Cho HY, Chung SE, Kim JI, et al. Spontaneous Reattachment of Rhegmatogenous Retinal Detachment. Ophthalmology. 2007. 114:581–586.
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