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from symptom onset to consultation (SO-C) and only SO-C 31-60 days was associated with PVR severity, yet dose-response relationship was not appeared. This might be due to information bias, unevenly distributed samples in each category or some unmeasured confounding factors. The TDH of more than 120 km was significantly associated with 6mo-FA. This finding reflects that travel distance may impact the willingness of the patient to complete their follow-up treatment in addition to other socioeconomic reasons. However, the result obtained in this study demonstrated that TDH of more than 120 km did not prevent 6mo-FA, this might be influenced by the area of origin, its devel-opment index, infrastructure and transportation system availability.As mentioned by Mitry et al., cases from more deprived regions appear to present later with extensive detachments and have significant impli-cations for the final visual prognosis10). Longer period from symptom onset to consultation was associated with PVR severity in our study was also mentioned in previous studies11, 12). Age, gender11) and ethnicity12, 13) strongly affected the incidence of RD. In this study, the male population was predom-inant as also seen in several studies11, 12, 14, 15). In terms of age, our result was in agreement with Chandra et al., that RD may occur at a younger age in Asians (46.1 years) as indicated in other studies13, 14, 16, 17). The above results, even after adjustment for age and gender in the multivariate analysis, suggest the importance of the impact of distance to the healthcare facility on RD care. In Indonesia, the distance of more than 120 km to the healthcare facility in some areas is a burden espe-cially when the areas are not traversed by an adequate transportation system. Meanwhile, not all residents in the peripheral area have private vehi-cles or can afford to arrive by plane; some of them have to wait for their family members to drive them. This problem was also mentioned by Kelly et al. and Mattson: in rural areas, great travel distance, less public transportation, and inconvenient trans-portation schedule could play a significant role7, 8). There is still a tendency to use private vehicles for mobilization within and between cities in Indonesia. During this research period, the development of intercity buses between provinces on the island of Java hasn’t been experienced growth and fluctu-ated18) despite the fact that the Indonesian govern-ment has been accelerating infrastructure develop-ment in transportation especially the highway construction and railway transportation services improvement19).The majority of the patients in this study presented late and had their macula off. This was in line with other studies in developing or third world countries, i.e., many RD patients presented late, which varied from about 2 weeks4, 20) more than one month21, 22), and more than 3 months after the onset of symptoms3, 20). As such, eyes with a long RD duration had significantly poorer visual acuity both at the initial and follow-up examinations23). Another study in Southwest Ethiopia showed many things in common with our study in terms of the average travel distance for patients (average travel distance of 87.5 km±120.7 km) and PVR severity significantly associated with delay in presenta-tion22). A study in Kwazulu-Natal revealed that few patients returned for follow-up or re-open, which meant that the definite success rate was uncer-tain2). This represents variations in the complexity of the cases, facilities, retina specialist distribution, and willingness for the treatment follow-up.The likely contributory factors in the delayed presentation include patients’ personal factors, facilities, and doctors’ delays. The patients’ factors include long travel distance24), lack of knowledge3) or unfamiliarity of the symptoms3, 25-27), lack of affordability20, 24), lack of health insurance or coverage for the limited procedure20) and lack of aware-ness24, 26, 28, 29). As mentioned in other studies, patients from peripheral areas might first attend their nearest optometrist4, 30) and consider the elon-gated distance4, 24) and were referred elsewhere before presenting to the referral center4, 30). While most of our patients arrived late for many reasons including long travel distances, lack of financial and ignorance of symptoms, the distance they would have to travel to the tertiary hospital affects their decision. This includes transportation fees, accom-modation expenses, and meal allowance for their companions during treatment, especially when the patients require hospitalization for surgical proce-dures that may take several days or weeks. Addi-tional sources of late presentation are scarcity of facilities24) and clinical resources3), lack of primary eye care2, 24) and lack of vitreoretinal surgeons20, 24). 41