The Impact of Travel Distance to Delayed Presentation and Follow-up Attendance of Retinal Detachment Cases in Surabaya, Indonesia

Abstract

Objectives To assess the delayed presentation of Retinal Detachment (RD), its association from travel distance to the referral hospital (TDH), the period from symptom onset to consultation (SO-C), Proliferative vitreoretinopathy (PVR) severity, and 6 months follow-up attendance (6mo-FA). Method A retrospective review based on medical records. Age, sex, initial best-corrected visual acuity (BCVA), TDH, SO-C, PVR type, and 6mo-FA were recorded. Multivariable ordered logistic regression was used to analyze the association between TDH and SO-C, and SO-C and PVR severity. Multivariable logistic regression was used to analyze 6mo-FA according to TDH. Multiple linear regression was used to assess the association between initial BCVA and TDH. Age and sex were included in all multivariable adjustments. Results A total of 387 patients had RD with 59.2% predominantly males and the mean age±SD was 46.3±13.9 years. The initial BCVA of less than 3/60 was 81.1%. The averages of SO-C and TDH were 183.5±456 days and 160.9±364 km, respectively. The TDH of more than 120 km distance was significantly associated with longer SO-C (adjusted OR 1.78; CI 95% 1.09-2.92). PVR was noted in 17.6% of patients. The SO-C of 31-60 days was significantly associated with PVR severity (adjusted OR 4.28; CI 95% 1.47-12.51). The TDH of more than 120 km distance was significantly associated with 6mo-FA (adjusted OR 0.46; CI 95% 0.27-0.93). Conclusions Long TDH was significantly associated with a longer period from symptom onset to consultation and 6mo-FA. Hence, accessible eye care is essential to refer RD cases in a timely fashion.

Minimizing Proliferative Vitreoretinopathy Reaction in Rhegmatogenous Retinal Detachment: Is There a Role of Preoperative Anti-Inflammatory?

“…Given this constraint, further exploration into alternative interventions beyond surgical management to mitigate PVR development before surgery, especially in locales where vitreoretinal surgical resources are sparse, offers a promising trajectory for elucidating comprehensive rhegmatogenous retinal detachment (RRD) management. 14…”