Risk Factors for Rhegmatogenous Retinal Detachment: A Systematic Review of Cohort Studies with Meta-Analysis

Identifying and systematizing risk factors for the development of rhegmatogenous retinal detachment (RRD) remains a key challenge in modern ophthalmology.

The aim of this review is to analyze, summarize, and quantify current data on risk factors for the development of RRD.

Methods. The review included an analysis of Russian- and English-language publications of cohort studies in PubMed, Google Scholar, CyberLeninka, and Elibrary. The protocol was registered on PROSPERO (CRD420251272654).

Results. The initial search strategy and reference list analysis yielded 1,175 publications potentially relevant to the topic of research. After screening for inclusion/non-inclusion criteria and removing duplicates, the final sample for qualitative synthesis included 22 studies. Studies with no restrictions were selected for quantitative synthesis (meta-analysis calculations). Myopia is a dominant predictor of RRD. The presence of myopia increases the risk RRD by 2.98 (95 % CI: 2.95–3.02) times. A change in the spherical equivalent by 1 diopter towards myopia increases the risk RRD by 1.31 (95 % CI: 1.26–1.35) times. Other significant ophthalmologic factors include degenerative changes in the retinal periphery, posterior uveitis (especially of cytomegalovirus and herpes etiology), glaucoma, hypotony, previous eye surgery, and the presence of detachment in the fellow eye. A meta-analysis revealed consistent demographic patterns: the mean age at onset was 56.5 years (95 % CI: 48.08–64.18), with a male predominance (66.6 %, 95 % CI: 56.2–77.0) and right eye involvement (52.0 %, 95 % CI: 50.5–53.4). Male gender increases the OR and risk of RRD by 2.32 (95 % CI: 2.30–2.34) and 2.75 (95 % CI: 2.70–2.74) times, respectively. A significant association was found with comorbid conditions that increase the risk of the disease: inflammatory processes (periodontitis), cardiovascular disease, diabetes mellitus, chronic obstructive pulmonary disease, obesity, and mental disorders. The influence of socioeconomic factors was established: the higher the level of education and income and the more developed the area of residence, the higher the risk. Regular heavy lifting increases the probability of developing RRD.

Conclusion. The findings of the study highlight the need for a comprehensive approach to risk stratification and targeted preventive monitoring of high-risk patients, which is of paramount importance for improving functional outcomes.

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