Epidemiology of giant retinal tears in the United Kingdom: the British Giant Retinal Tear Epidemiology Eye Study (BGEES).

PURPOSE

To determine the incidence of giant retinal tear (GRT) in the United Kingdom and to provide epidemiologic data, clinical characteristics, treatment methods, and short-term outcomes in affected and fellow eyes.

METHODS

Patients with a newly developed GRT (90 degrees or greater in circumferential extent associated with posterior vitreous detachment) were identified prospectively over a 13-month period (January 2007-January 2008, inclusive) by active surveillance through the British Ophthalmic Surveillance Unit. Questionnaire-based data were obtained from reporting ophthalmologists at baseline and 12 months.

RESULTS

Sixty patients (62 eyes) developed a new GRT, giving a U.K. annual incidence of 0.094 (95% CI 0.072-0.120) cases or 0.091 (95% CI 0.069-0.117) patients per 100,000. The GRTs were mostly idiopathic (54.8%), affected middle-aged (mean, 42.2 years), white British (93.3%) males (71.7%), with presenting vision worse than 20/40 in 59.7%, foveal detachment in 45.2%, and proliferative vitreoretinopathy of grade C (PVR-C) or worse in 11.3%. Treatment in most was managed by pars plana vitrectomy (93.5%) with laser retinopexy (52.5%) and silicone oil endotamponade (75.8%). Prophylactic 360 degrees laser or cryotherapy was applied to 39.0% of the fellow eyes. At mean follow-up of 11.3 months, eventual retinal reattachment was attained in 94.7%, although only 42.1% achieved vision of >or=20/40. Neither GRT nor RD developed in any of the 19 nontraumatic, noniatrogenic, prophylactically treated fellow eyes.

CONCLUSIONS

This study is the first population-based prospective effort to evaluate the epidemiology of GRT. Although only a minority presented with PVR-C and high retinal reattachment rates were achieved, fewer than half had vision sufficient for driving in the GRT eye.