In New Zealand, rhegmatogenous retinal detachment (RRD) is recognised as a serious and potentially blinding disorder but little is known about the prevalence, risk factors, management and outcomes for treatment for our population. This thesis attempts to investigate these issues and part of that documentation involved a clinical review of those individuals presenting with RRD. That survey was performed over a 16 month interval enabling the annualised rate for individuals presenting with a new RRD to be determined. The prevalence was found to be 11.8 per 100,000. The risk was age-related with the incidence of RRD increasing for each decade up until the age of 70 years. Men had a slightly greater risk of RRD, and high myopes (greater than 6 dioptres) accounted for approximately 1/3 of the presentations. A history of cataract surgery was also noted to be a significant risk factor for RRD. A subsequent investigation documented in this thesis determined the rate of RRD following cataract surgery using phaco-emulsification techniques was 1%. The risk for pseudo-phakic patients was inversely related to age. The initial survey revealed approximately 2/3 of the patients presented with macula-off RRDs. While individually many of these patients did well, as a group the functional improvement following surgery was limited and less than 1/3 of eyes achieved LogMAR 0.3. It was not always apparent what factors negatively impacted on the functional prognosis but certainly those individuals requiring more than one surgery tended to fare worse. The impact of a poor visual outcome was not directly assessed in this thesis but it is likely those individuals do suffer in terms of visual functioning and quality of life issues. In New Zealand there are a number of agencies that care and support visually impaired persons but there is inadequate data to assess and benchmark treatment and rehabilitation. If this could be achieved for patients with RRD then those barriers which potentially restrict successful outcomes might provide useful insight for other individuals with visual impairment.
| Identifer | oai:union.ndltd.org:ADTP/269296 |
| Date | January 2007 |
| Creators | Polkinghorne, Philip John |
| Publisher | ResearchSpace@Auckland |
| Source Sets | Australiasian Digital Theses Program |
| Detected Language | English |
| Rights | Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated., http://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm, Copyright: the author |
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