Summary
BACKGROUND: In literature, women are reported to be more likely to turn to a doctor or preventive medical checkup. In ophthalmology, there are only a few studies regarding this issue. In our study we aimed to evaluate gender specific differences in rhegmatogenous retinal detachment. METHODS: All patients with rhegmatogenous retinal detachment (n=103), referred to the Department of Ophthalmology at the Medical University of Vienna within one year, were evaluated retrospectively. Age, Gender, duration of symptoms, referral, size of detachment, kind of surgery, visual acuity pre- and postoperatively, time to surgery were collected. RESULTS: 58.3% of patients were male, 41.6% female. Mean age at time of surgery was 58.3 years. Women tended to be older than men (57.4 vs. 59.6 years, p = 0.481). Mean duration of symptoms was 14.2 days. Women waited twice as long as men (10 vs. 20 days, p = 0.066). Women were more likely to suffer from proliferative vitreoretinopathy (PVR) (7.0% vs. 1.7%, p = 0.306), men were more likely to have macula-off retinal detachment (72.1% vs. 53.3%, p = 0.066). Preoperatively visual acuity was slightly better in female patients (0.38 vs. 0.41 Snellen, p = 0.748), postoperatively visual gain was higher in women (0.38 vs. 0.48 Snellen, p = 0.166). Regarding the size of retinal detachment, no gender specific differences were found. Surgery was performed at a mean of 0.55 days without gender specific differences. Women were more likely to be treated with buckling procedures (97.7% vs. 78.3%, p = 0.007), men with gas tamponade (26.7% vs. 11.6%, p = 0.083). CONCLUSIONS: Women are treated with a longer duration of symptoms and a higher rate of PVR. Symptoms might progress slower in women, they are more likely to have macula still attached. Altogether a mean duration of symptoms of 14 days is way too long. Better education of patients could result in earlier treatment and higher success rates.
Zusammenfassung
HINTERGRUND: Frauen gehen laut Literatur öfter zum Arzt und zu Vorsorgeuntersuchungen. Im Bereich der Augenheilkunde gibt es nur wenige Studien zu genderspezifischen Unterschieden. Ziel dieser Studie war es, geschlechtsspezifische Unterschiede bei PatientInnen mit rhegmatogener Ablatio retinae zu evaluieren. METHODE: Retrospektiv wurden die Daten von allen PatientInnen (n = 103), die innerhalb eines Jahres mit rhegmatogener Ablatio retinae an die Universitätsaugenklinik, AKH Wien, kamen, evaluiert. Alter, Geschlecht, Symptomdauer, Vorliegen einer Facharzt-Zuweisung, Ausmaß der Ablatio, Art der Versorgung, Visus prä- und postoperativ sowie Wartezeit bis zur Operation wurden erhoben. ERGEBNISSE: 58,3% der PatientInnen waren männlich. Das Durchschnittsalter war 58,3 Jahre, Frauen waren etwas älter als Männer (57,4 vs. 59,6 Jahre, p = 0,481). Die durchschnittliche Symptomdauer war 14,2 Tage. Frauen warteten doppelt solange wie Männer (10 vs. 20 Tage, p = 0,066). Bei Patientinnen wurde häufiger eine proliferative Vitreoretinopathie (PVR) gefunden (7,0% vs. 1,7%, p = 0,306), allerdings war die Makula häufiger anliegend (72,1% vs. 53,3%, p = 0,066). Der präoperative Visus war bei Frauen tendenziell besser (0,38 vs. 0,41 Snellen, p = 0,748), auch postoperativ schnitten sie besser ab (0,38 vs. 0,48 Snellen, p = 0,166). Bezüglich des Ausmaßes der Ablatio gab es keine signifikanten Unterschiede. Die Operation erfolgte durchschnittlich nach 0,55 Tagen, auch hier zeigten sich keine signifikanten Unterschiede. Patientinnen wurden häufiger mit Plombe oder Cerclage versorgt (97,7% vs. 78,3%, p = 0,007), Patienten erhielten öfter eine Gastamponade (26,7% vs. 11,6%, p = 0,083). SCHLUSSFOLGERUNGEN: Patientinnen kommen mit deutlich längerer Symptomdauer und höherer PVR-Rate zur Ablatio-Operation. Allerdings dürfte bei Patientinnen, die Symptomatik weniger rasch fortschreiten, die Macula ist noch häufiger anliegend. Insgesamt ist eine durchschnittliche Symptomdauer von 2 Wochen als zu lang zu werten. Bessere Aufklärung der PatientInnen könnte zu einer früheren Versorgung und damit zu einer höheren Erfolgsrate beitragen.
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Weingessel, B., Fischl, J. & Vécsei-Marlovits, P. Gibt es geschlechtsspezifische Unterschiede bei rhegmatogener Ablatio retinae?. Spektrum Augenheilkd. 24, 316–321 (2010). https://doi.org/10.1007/s00717-010-0448-0
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DOI: https://doi.org/10.1007/s00717-010-0448-0