Increasing frequency of hospital episodes for retinal detachment in England 2000-2015

Session Details

Session Title: Free Paper Session 1: Vitreoretinal Surgery I

Session Date/Time: Thursday 07/09/2017 | 09:00-10:30

Paper Time: 09:12

Venue: Room 111

First Author: : J.Keller UK

Co Author(s): :    R. Haynes   M. Majid   R. Markham                       

Abstract Details

Purpose:

To analyse changes in reported frequency of retinal detachment hospital admissions and vitreo-retinal surgery procedures performed between 2000 and 2015. To obtain information contributing towards the planning of service delivery.

Setting:

England, nationwide

Methods:

Analysis of Hospital Episode Statistics from the Health and Social Care Information Centre, population data from the Office for National Statistics, disease prevalence data from the NHS Primary Care Trusts and diabetic retinopathy screening performance indicators from Public Health England.

Results:

The total number of retinal detachment hospital episodes increased from 8513 (17.3/100M population) to 13991 (25.8/100M) from 2000-01 until 2014-15. Episodes of “retinal detachments with breaks” increased year on year from 3447 (7.0/100M) to 9339 (17.2/100M), whereas records of “tractional retinal detachment” increased from 290 (0.6/100M) to 742 (1.4/100M). Serous retinal detachment episodes have decreased from 3941 (8.0/100M) to 3541 (6.5/100M). The number of reported pars plana vitrectomies irrespective of indication increased almost fivefold from 5761 to 27365, while records of scleral buckling as main procedure decreased by two thirds from 2897 to 861. During the same period the population of England increased from 49.2MM to 54.3MM. The prevalence of diabetes mellitus increased year on year since 2005 until 2015 from 3.6% to 6.2%.

Conclusions:

The frequency of admissions to hospital for surgical retinal detachments seems to have been increasing significantly since 2000. This effect is more marked in cases of rhegmatogenous retinal detachment. Possible explanations for the latter include increases in cataract surgery and high myopia, ageing of the population, improvements in patient access, increased repeated procedures, and increased public awareness. The raising prevalence of diabetes mellitus is likely to explain the increase in frequency of tractional retinal detachment. It is also possible that these observations are due in part to changes in methodology of hospital coding. As the frequency of retinal detachment continues to increase, retinal services in England will need to prepare to address the demand.

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