Rhegmatogenous retinal detachment in Canadian population: a retrospective cohort study examining incidence and risk factors

OBJECTIVE: To measure the incidence and risk factors of rhegmatogenous retinal detachment (RRD) in a Canadian population from 2010 to 2023. DESIGN: A retrospective cohort study. PARTICIPANTS: Patients with ICD-10 diagnostic code H33.0 (retinal detachment with retinal break) and controls who had cataract surgery but no prior history of detachment, age (±2 years) and sex-matched. METHODS: Patients reporting to the QEII Health Sciences Centre between January 1, 2010, to December 31, 2023, were included. The primary outcome was the incidence rate of RRD estimated using negative binomial regression. Generalized linear model was used to compare the risk of RRD and Cox-proportional hazards to model time to RRD following cataract surgery. RESULTS: Annual RRD incidence rates increased from 15.2 to 27.5 cases per 100,000 between 2010 and 2023. Mean axial length of RRD patients with prior cataract surgery was 25.0 (1.55) mm compared with the control population of 24.1 (1.60) mm. An increased risk of RRD was associated with each 1-mm increase in axial length (hazard ratio [HR] 1.31), male sex (HR 1.29), and per 1 year age increase (HR 1.03) post-cataract surgery. Time-to-event analyses identified that the mean time from cataract surgery to RRD was 9.43 years. CONCLUSIONS: Increases in RRD cases have been seen over the last 14 years. While the total risk for RRD is still small, male sex and a 1-2 mm increase in axial length can significantly change a patient's risk. Furthermore, the increased risk of RRD after cataract surgery is not only an early event.