ZURÜCKGEZOGEN: Periphere Netzhautdegenerationen—Behandlungsempfehlungen

A survey of rhegmatogenous retinal detachment during 1976 was conducted on the population of Iowa. The annual incidences (per 100,000 populations) of four types of detachment were determined: nontraumatic phakic (6.1), traumatic phakic (1.0), nontraumatic aphakic (4.9), and traumatic aphakic (0.4). The incidences of nontraumatic phakic detachment for men and women were similar, although there was a preponderance of women that reflected their greater representation in the general population. The proportions of men were significantly higher in traumatic detachments compared with nontraumatic detachments. Men tended to be younger than women for all types of detachment; however, only in nontraumatic aphakic detachment was there a significant difference between mean ages. There was an insignificant preponderance of right eye involvement in all four detachment groups.

We studied the incidence of rhegmatogenous retinal detachment in Rochester, Minnesota, for the nine-year period from 1970 through 1978. The age-adjusted rate for idiopathic rhegmatogenous retinal detachment was 10.1 per 100,000 population per year (45 cases). Including 12 cases of aphakic retinal detachments, the age-adjusted incidence was 12.9 per 100,000 population per year. Not surprisingly, the incidence rate increased with age in both sexes. By extrapolation from the Rochester rates, the number of cases per year of idiopathic retinal detachment in the United States would be expected to be about 22,000, and the number of both aphakic and idiopathic phakic cases per year would be expected to approach 28,000.

An initial series of patients with lattice degeneration was reported to the Academy in 1964 and a follow-up report given in 1973. A continuing prospective study of 276 consecutive untreated patients (423 eyes) is now reported with follow-up from 1 to 25 years (average, 10.8 years). Clinical retinal detachments (RDs) occurred in 3 (1.08%) of 276 patients and 0.7% of eyes. Tractional retinal tears were seen in eight (2.9%) patients and 1.9% of eyes; one of these led to a clinical RD. Clinical or progressive subclinical RD occurred in 3 (2%) of eyes with atrophic holes. Subclinical RD was seen in 10 (6.7%) of 150 eyes with atrophic holes, involving 9 (7.5%) of 120 patients, and had a much less serious prognosis than clinical detachment. Prophylactic treatment of lattice with or without holes in phakic, nonfellow eyes should be discontinued.