Increasing frequency of hospital admissions for retinal detachment and vitreo-retinal surgery in England 2000-2018

Abstract

Objectives To analyse the changes in reported frequency of retinal detachment admissions and vitreo-retinal surgery procedures performed between 2000 and 2018 in England. To obtain information useful to contribute towards the planning of service delivery. Methods Analysis of England's Hospital Episode Statistics from the Health and Social Care Information Centre and population data from the United Kingdom's Office for National Statistics. Results Episodes of "retinal detachments with breaks" increased year on year from 3,447 (7.0/100M) in 2000 to 10,971 (19.7/100M) in 2018 (p <0.001), whereas records of "tractional retinal detachment" increased from 290 (0.6/100M) to 910 (1.6/100M) in the same period (p <0.0001). The number of reported pars plana vitrectomies irrespective of indication increased over fourfold from 5,761 to 26,900 (p <0.0001), while the number of scleral buckling records decreased by two thirds from 2,897 to 780 (p <0.0001). During the same period the population of England increased from 49.2 million to 55.6 million, proportionally at a slower rate than that for recorded hospital episodes. Conclusions The frequency of admissions to hospital for surgically treated retinal detachment seems to have been increasing significantly since 2000. This effect is more marked in cases of rhegmatogenous retinal detachment. This may be partially explained by repeat surgery in cases of recurrent retinal detachment. Other possible explanations may be increased incidence of disease (due to increased rates of cataract surgery, increasing longevity and increasing rates of myopia), improvements in patient access, and increased public awareness. It is possible that this observation is due in part to local changes in methodology of hospital coding.

Substantial increase in the incidence of rhegmatogenous retinal detachment in Western Norway over 20 years

“…This longitudinal study on changes in the incidence of primary RRD in Western Norway reproduced recent findings from Danish, Dutch and British populations, where the RRD incidence increased dramatically in the past decade (Nielsen et al. 2020; Madi & Keller 2021; van Leeuwen et al. 2021).…”

“…The risk of RRD peaks in the age groups 50-70 years when the vitreous liquefies and separates from the neurosensory retina (Ghazi & Green 2002;Mitry et al 2010). The mean age at RRD presentation was 58.8 years, similar to findings in former studies (Van de Put et al 2013;Li et al 2019;Madi & Keller 2021;Yorston et al 2021). When adjusting for the age and sex distribution of the South Rogaland population in 2000, we found that demographic changes accounted for approximately 30% of the incidence increase from 2000 to 2019.…”