Retinal detachment in black South Africans.

Rhegmatogenous retinal detachments seen in black patients attending King Edward VIII Hospital Ophthalmology Clinic over a 5-year period from January 1987 to December 1991 were reviewed. Penetrating trauma and diabetic retinopathy were excluded. There were 114 detachments in 112 patients, which gave incidence of 0.46/100,000 of the population served per annum. This confirms the low incidence of this disorder found in black patients in other series. Patients were comparatively young (37.5% less than 30 years of age), men outnumbered women 2:1, and the incidence of blunt trauma was high (29.8%). Over one-third (36.6%) presented with a blind or poorly sighted opposite eye. Late presentation was common. Large posterior breaks occurred in 15.7% of detachments with severe proliferative vitreoretinopathy in 33.3%. These last characteristics accounted for the use of vitrectomy with tamponade as a primary surgical procedure in 32.5% of cases and contributed to the relatively low success rate of reattachment (72.8%). Some of the findings may be influenced by social disadvantage, but the reason for the low incidence of retinal detachment in black patients is not known. A stronger adherence of the retina to the retinal pigment epithelium in black patients is postulated.