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Published on: September 11, 2013
Characteristics and surgical outcomes of paediatric retinal detachment
T Yokoyama1, T Kato, A Minamoto
1Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Japan.
Insights
Pediatric rhegmatogenous retinal detachment (RRD) often presents with delayed diagnosis and proliferative vitreoretinopathy (PVR). Early detection is crucial for improving visual outcomes in children with RRD.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Pediatric Eye Care
Background:
- Rhegmatogenous retinal detachment (RRD) in children is uncommon, representing a small percentage of all RRD cases.
- Causes vary, including blunt trauma, myopia, and genetic conditions, often leading to delayed diagnosis.
Purpose of the Study:
- To detail the clinical characteristics of pediatric RRD.
- To evaluate surgical and visual outcomes following RRD repair in children.
- To identify factors influencing treatment success and visual prognosis.
Main Methods:
- Retrospective review of pediatric patients (0-15 years) undergoing primary surgical repair for RRD.
- Data collected included causes of RRD, preoperative proliferative vitreoretinopathy (PVR) status, and visual acuity.
- Surgical and final visual outcomes were analyzed.
Main Results:
- Paediatric RRD constituted 3.1% of all operated RRDs.
- Blunt trauma (27%) and myopia (25%) were leading causes.
- 78% achieved reattachment with a single surgery; 87% ultimately reattached.
- Preoperative PVR significantly impacted reattachment rates (42% with PVR vs. 100% without).
- Median final visual acuity was 0.7, with 73% achieving ≥0.1.
Conclusions:
- Pediatric RRD is frequently diagnosed late, indicated by a high prevalence of PVR at presentation.
- PVR negatively affects retinal reattachment success.
- Initial visual acuity and preoperative PVR are significant predictors of final visual outcomes.
- Prompt diagnosis and intervention are essential for better visual prognosis in pediatric RRD.
Purpose:
To report the clinical features and surgical and visual outcomes of rhegmatogenous retinal detachment (RRD) in the paediatric population.
Methods:
A retrospective review of children (aged 0-15 years) who underwent primary surgical repair for RRD at the Hiroshima University Hospital between 1988 and 2001.
Results:
In all 53 eyes of 49 patients were identified; paediatric RRD accounted for 3.1% of 1779 eyes with RRD operated on during this period. The causes of RRD included blunt trauma (27%), myopia (25%), idiopathic (20%), familial exudative vitreoretinopathy (13%), and others. Among 55 eyes, 12 (22%) already had proliferative vitreoretinopathy (PVR) of grade C or D preoperatively. The median initial visual acuity (VA) was 0.3. Retinal reattachment was achieved with a single operation in 78%. Final retinal reattachment was achieved in 87%. Retinal reattachment rates with and without PVR were 42% and 100%, respectively (P<0.01). Median final VA was 0.7. Final VA was > or =0.1 in 73% and > or =0.5 in 53%; four eyes had a final VA of no light perception. The presence of preoperative PVR (P=0.03) and the initial VA (P<0.0001) significantly affected final VA.
Conclusions:
Paediatric RRD is characterised by a delay in diagnosis, as evidenced by the high rate of PVR at presentation. Retinal reattachment was adversely affected by the presence of PVR. Final VA correlated with the initial VA and was significantly affected by preoperative PVR. Early diagnosis may improve the visual prognosis of paediatric retinal detachment.
