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Sauli Ari WIDJAJA1, 3), Yoshimune HIRATSUKA1), Koichi ONO2), Muhammad FIRMANSJAH3), Wimbo SASONO3), Akira MURAKAMI1)3)Department of Ophthalmology, Faculty of Medicine Universitas Airlangga/ 1)Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan2)Department of Ophthalmology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan36Corresponding author: Sauli Ari Widjaja (ORCiD: 0000-0002-7033-524X)Department of Ophthalmology, Juntendo University Graduate School of Medicine2-1-1 Hongo Bunkyo-ku, Tokyo 113-8421, Japan TEL: +81-3-3813-5537　Cellular phone: +62-8123001724　E-mail: w-sauli@juntendo.ac.jp/sauliawidjaja@gmail.com〔Received　Sep. 7, 2021〕〔Accepted　Nov. 5, 2021〕J-STAGE Advance published date: Feb. 4, 2022Copyright © 2022 The Juntendo Medical Society. This is an open access article distributed under the terms of Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original source is properly credited. doi: 10.14789/jmj.JMJ21-0024-OAObjectives: To assess the delayed presentation of Retinal Detachment (RD), its association from travel distance to the referral hospital (TDH), the period from symptom onset to consultation (SO-C), Proliferative vitreoretinopathy (PVR) severity, and 6 months follow-up attendance (6mo-FA).Method: A retrospective review based on medical records. Age, sex, initial best-corrected visual acuity (BCVA), TDH, SO-C, PVR type, and 6mo-FA were recorded. Multivariable ordered logistic regression was used to analyze the association between TDH and SO-C, and SO-C and PVR severity. Multivariable logistic regression was used to analyze 6mo-FA according to TDH. Multiple linear regression was used to assess the association between initial BCVA and TDH. Age and sex were included in all multivariable adjustments.Results: A total of 387 patients had RD with 59.2% predominantly males and the mean age±SD was 46.3±13.9 years. The initial BCVA of less than 3/60 was 81.1%. The averages of SO-C and TDH were 183.5±456 days and 160.9±364 km, respectively. The TDH of more than 120 km distance was significantly associated with longer SO-C (adjusted OR 1.78; CI 95% 1.09-2.92). PVR was noted in 17.6% of patients. The SO-C of 31-60 days was significantly associated with PVR severity (adjusted OR 4.28; CI 95% 1.47-12.51). The TDH of more than 120 km distance was significantly associated with 6mo-FA (adjusted OR 0.46; CI 95% 0.27-0.93).Conclusions: Long TDH was significantly associated with a longer period from symptom onset to consultation and 6mo-FA. Hence, accessible eye care is essential to refer RD cases in a timely fashion.Key words: retinal detachment, delayed presentation, symptom onset, follow-up attendance, health system, accessibleJuntendo Medical Journal2022. 68(1), 36-43Original ArticlesThe Impact of Travel Distance to Delayed Presentation and Follow-up Attendance of IntroductionPermanent blindness is often caused by retinal disease, glaucoma, and other disorders that present late or with insufficient care1). Furthermore, delay in bringing retinal detachment (RD) cases to retinal specialists tends to be a trend in developing coun-tries, the treatment of which has been a minor Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesiapriority2). Lack of education, access, and inadequate healthcare coverage are probable contributing factors3). At many stages in the healthcare phase, delays between first symptoms and surgical repair may occur, which can be either from the doctor or the patient4). In one study from Indonesia, child-hood RD was revealed to often arrive late for assessment5). Other studies pointed out that patients Retinal Detachment Cases in Surabaya, Indonesia