Author: Walter Andreatta (Switzerland)
Co-authors: George Moussa, Emma Samia-Aly, Soon Ch'ng
To investigate different baseline characteristics, clinical indications, repeat retinopexy rate, and six-month detachment rate of primary laser retinopexy across different ethnicities.
The Birmingham and Midland Eye Centre, United Kingdom
Retrospective, single centre, consecutive comparative study, looking at all patients who had primary laser retinopexy between January 2017-2020. Multivariate Cox survival (reporting Hazard Ratio [HR]) and binary logistic regression (reporting Odds Ratio [OR]) analyses were performed to investigate differences between ethnicities with age, gender, operator level (vitreo-retinal or general ophthalmologist) and high myopia status (≤-6.0Dioptres) as covariates.
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 six-month detachment rate of 31 (3.8%). Rate for subsequent retinopexies were 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. SA had lower repeat retinopexy rate than White patients (HR0.40 [95%CI0.22-0.71,p=0.002). Multivariate binary logistic regression found that Black and SA patients compared to White, have: i) higher proportion of round holes relative to horseshoe tears (OR2.31[95%CI1.19-4.49,p=0.014] and OR2.06[95%CI1.25-3.40],p=0.004 respectively), ii) higher proportion of high myopia (OR2.99 [95%CI1.20-7.46,p=0.019] and OR2.35[95%CI1.11-4.96],p=0.025 respectively). Ethnic minorities were younger than White patients: SA [43,IQR28-61], Black [49,IQR35-57] and White [61,IQR54-67] years, p<0.001) and had more indirect and 360-retinopexy compared to slit-lamp (p<0.001).
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 healthcare.