Women, Asian, Comorbid Patients with Myopia Face Worse Retinal Detachment Risk


New AAO 2020 findings suggest even geographical differences could define retinal detachment risks among nearsighted patients.


Differing regions and patient demographics, as well as conditions including glaucoma and vitreous degeneration, are associated with rising or falling risk of retinal detachment among patients with severe myopia.

In a presentation at the American Academy of Ophthalmology (AAO) 2020 Virtual Meeting this week, a team of investigators shared results from a retrospective cohort analysis showing trends of retinal detachment risk among patients with a severe form of nearsightedness, over a span of 5 years.

The US-based team of investigators, led by Danielle Fujino, MPH, sought to assess baseline characteristics associated with the development of retinal detachment in this very common patient population. Their cohort included patients with severe myopia, never previously diagnosed with retinal detachment, logged in the AAO’s IRIS Registry from 2013-2018.

Fujina and colleagues observed data from 433,022 eligible patient eyes for a median follow-up period of 284 days. Of this population, 7406 (1.71%) had experienced retinal detachment in a median time of 693 days.

A Cox proportional hazards model which adjusted for patient sociodemographics and comorbid conditions showed female eyes with severe myopia faced increased retinal detachment development risk versus males (hazard ratio [HR], 0.58; P <.0001).

Asian patients with severe myopia were also at a greater risk of development than white patients (HR, 0.76; P <.0001). Interestingly, investigators also observed a greater risk of retinal detachment development in patients in the Midwest versus those in the South (HR, 1.32; P <.0001).

Lastly, patients with severe myopia plus glaucoma and vitreous degeneration were at a 34% and 39% increased risk of developing retina detachment, respectively (P <.0001).

Though recent research suggests the risk of developing chronic, blinding ophthalmic conditions including age-related macular degeneration (AMD) are not linked to myopia, there is a growing effort to address the extremely common issue of nearsightedness with therapeutic solutions.

Just last year, the US Food and Drug Administration (FDA) approved the MiSight contact lens, a single use, disposable, soft contact lens that slows the progression of myopia in children aged 8-12 years old—a first-of-its-kind indication.

Whether such advances would eventually curb the rate of retinal detachment is not definite, but Fujino and colleagues nonetheless concluded that particularly female, Asian, and ophthalmic-comorbid patients with myopia are at a notably greater risk of retinal detachment.

The study, “Baseline Factors Influencing Time to RD in Patients With Severe Myopia: An AAO IRIS® Registry Analysis,” was presented at AAO 2020.

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