Fellow Eye Risk of Rhegmatogenous Retinal Detachment in the United States: IRIS Registry (Intelligent Research in Sight) Analysis

BACKGROUND AND OBJECTIVE: This study aimed to investigate the rate of rhegmatogenous retinal detachment (RRD) in the fellow eye of patients after developing an RRD in one eye. PATIENTS AND METHODS: This is a retrospective cohort study of patients with a new RRD diagnosis in the American Academy of Ophthalmology IRIS Registry (Intelligent Research in Sight) from 2016 to 2020. The association between risk factors of RRD and fellow-eye RRD was evaluated using Cox regression. RESULTS: Among the 201,622 patients who developed a new RRD in at least one eye, 6,740 (3.34%) developed an RRD in the fellow eye at a mean time of 406.02 days (SD = 373.74) from the first eye diagnosis. Of those 6,740 eyes, 1,889 (28.03%) had lattice degeneration, 3,938 (58.43%) had PVD, 588 (8.72%) had cataract surgery, and 38 (0.56%) had complex cataract surgery. Adjusted regression modeling showed that male sex (HR 1.73, [95% confidence interval (CI) 1.64 to 1.83]; P < 0.001), younger age at first eye RRD diagnosis (HR 1.02, [95% CI 1.01 to 1.02]; P < 0.001), active smoking (HR 1.13, [95% CI 1.05 to 1.22]; P = 0.002), and cataract surgery (HR 1.33, [95% CI 1.23 to 1.45]; P < 0.001) were associated with increased risk of a fellow eye RRD. On the other hand, fellow eye PVD was associated with a lower risk of RRD (HR 0.80, [95% CI 0.76 to 0.84]; P < 0.001). CONCLUSION: Among patients with an RRD in one eye, male sex, younger age of first eye RRD diagnosis, active smoking, and cataract surgery were associated with a higher risk of developing a fellow eye RRD, whereas fellow eye PVD was associated with a lower risk of fellow eye RRD.