Juvenile rhegmatogenous retinal detachment

To review the clinical features, evaluate visual, and anatomical outcomes and potential complications following surgery for rhegmatogenous retinal detachment (RRD) in juveniles.

Retrospective, consecutive case series of children and young adults (birth through 18 years) who underwent surgerys for RRD between February 1999 and January 2002.

The authors reviewed a consecutive series of 111 eyes of 105 juveniles [86 (77.47%) eyes belonged to male and 25 (22.52%) to female subjects] operated for RRD. The mean age of patients was 13.62 years. Bilateral retinal detachment was present in 12 (10.8%); 51 (46%) patients had some form of bilateral ocular pathology at initial presentation. The two most common aetiologies were non-penetrating trauma (45.04%) and myopia (41.44%). Decreased vision was the most frequent symptom. The mean duration of symptoms was 165.36 days. The commonest retinal break was a retinal hole (34.23%). Late diagnosis was common, evidenced by high frequency of macular detachment (97.29%) and proliferative vitreoretinopathy (PVR) (45.94%) at initial presentation. The most commonly performed primary surgery was scleral buckle (61.26%). The average postoperative follow-up after the first procedure was 10 months (range 8-19 months). Final retinal reattachment was accomplished in 78.37% (87/111) with a mean of 1.29 surgeries per eye. Improvement, no change and decline in vision was seen in 50 (48%), 32 (31%) and 22 (21%) eyes respectively.

Non-penetrating injury and myopia were the most common cause for RRD in juveniles. Fellow eyes commonly had vision-threatening abnormalities. Final anatomical and visual recovery rates were encouraging despite late initial presentation and high rates of macular detachment, and PVR at initial presentation.