Effect of demographics and ethnicity on laser retinopexy in preventing retinal detachment in a tertiary eye hospital in 812 eyes

Abstract

Purpose: To investigate different baseline characteristics, clinical indications, repeat retinopexy rate, and 6-month detachment rate of primary laser retinopexy across different ethnicities. Method: Retrospective, single-centre, consecutive comparative study, looking at all patients who had primary laser retinopexy between January 2017 and 2020. Multivariate Cox survival [reporting hazard ratio (HR)] and binary logistic regression (reporting odds ratio) analyses were performed to investigate differences between ethnicities with age, gender, operator level (vitreoretinal or general ophthalmologist) and high myopia status (≤−6.0 Dioptres) as covariates. Results: We report on 812 patients in three ethnicities: Black [69 (8.5%)], South Asian [SA, 156 (19.2%)] and White [587 (72.3%)] with overall 6-month detachment rate of 31 (3.8%). Rate for subsequent retinopexies was Black: 12 (17.4%), SA: 15 (9.6%) and White: 131 (22.3%), p = 0.002. Multivariate Cox survival regression analysis found no difference in detachment rate between ethnicities. South Asian (SA) had lower repeat retinopexy rate than White patients [HR, 0.40 (95% confidence interval [CI], 0.22–0.71, p = 0.002)]. Multivariate binary logistic regression found that Black and SA patients compared with White, have the following: (i) higher proportion of round holes relative to horseshoe tears [OR, 2.31 (95% CI, 1.19–4.49, p = 0.014) and OR, 2.06 (95% CI, 1.25–3.40), p = 0.004, respectively] and (ii) higher proportion of high myopia [OR, 2.99 (95% CI, 1.20–7.46, p = 0.019) and OR, 2.35 (95% CI, 1.11–4.96), p = 0.025, respectively]. Ethnic minorities were younger than White patients: SA [43, interquartile range (IQR), 28–61], Black (49, IQR, 35–57) and White (61, IQR, 54–67 years, p < 0.001) and had more indirect and 360 retinopexy compared with slit lamp (p < 0.001). Conclusion: We demonstrate a significant difference in baseline characteristics, retinal tear morphology and treatment course between the ethnic groups. Further studies are necessary to investigate the genetic and biological differences that may influence these variations and may help to allow for more targeted health care.