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Published on: September 11, 2013
[Clinical features and surgical outcomes of children with rhegmatogenous retinal detachments]
Lüe Li1, Fang-tian Dong, Jun-jie Ye
1Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
Insights
Pediatric rhegmatogenous retinal detachment (RRD) is often linked to trauma or congenital issues. While surgical reattachment is successful in most cases, visual recovery can be limited, necessitating early detection and regular follow-up.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Pediatric Eye Care
Context:
- Rhegmatogenous retinal detachment (RRD) in children is less common than in adults but can lead to significant vision loss.
- Identifying predisposing factors and understanding outcomes are crucial for managing pediatric RRD.
- This study reviews a series of pediatric patients undergoing surgical repair for RRD.
Purpose:
- To detail the clinical characteristics of pediatric RRD.
- To evaluate surgical and visual outcomes following primary repair of pediatric RRD.
- To identify predictors of visual outcomes in pediatric RRD.
Summary:
- Thirty-six eyes of 33 pediatric patients (≤14 years) with RRD were analyzed retrospectively.
- Common predisposing factors included trauma (36.1%), structural abnormalities (30.6%), high myopia, and prior intraocular surgery (19.4% each).
- Ultimately, retinal reattachment was achieved in 90.6% of eyes, but visual recovery was modest, with predictors of poor outcomes similar to adults.
Impact:
- Modern vitreoretinal surgical techniques can successfully reattach retinas in most pediatric RRD cases.
- Predictors of visual outcomes in pediatric RRD align with those seen in adult populations.
- Regular follow-up is essential for early detection and management of RRD in at-risk children.
Objective:
To describe the clinical features and surgical and visual outcomes in a series of children with rhegmatogenous retinal detachments (RRD).
Methods:
Retrospective case series of pediatric patients (14 years old or younger) with RRD who underwent primary surgery at a tertiary referral center between May 1995 and May 2006. Patients with perforating ocular trauma were excluded.
Results:
Thirty-six eyes of 33 patients were included in this study. The median age was 12 years, and 26 patients (78.8%) were male. Bilateral RRD was present in 10 patients (30.3%); 22 patients (66.7%) had some form of bilateral ocular pathology. At least one predisposing factor could be identified in 31 (86.1%) of eyes examined. Thirteen eyes (36.1%) experienced trauma, 11 eyes (30.6%) had structural abnormalities, high myopia and eyes underwent previous intraocular surgery were 7 (19.4%) each, and 3 eyes (8.3%) had inflammatory fundus disorders. Macular detachment was found in 28 eyes (77.8%). Median follow-up was 12 months. At the end of follow-up for this report, silicone oil was still in place in 4 eyes. Retinal reattachment was ultimately achieved in 29 of the 32 eyes (90.6%) with a mean of 1.9 surgeries per eye, however, visual recovery was modest. Predictors of a poor visual outcome were: hand motions or worse in preoperative vision (P = 0.001), macular-off retinal detachment (P = 0.003), proliferative vitreoretinopathy grade C or worse (P = 0.000), the need for vitrectomy surgery (P = 0.002), and the use of silicone oil (P = 0.005).
Conclusions:
Trauma and congenital or developmental anomalies were the most common predisposing factors for pediatric RRD in this series. Retinal reattachment can be achieved in most cases with modern vitreoretinal surgical techniques. Predictors of visual outcomes are similar to those observed in adults. Regular follow-up for children at risk of developing RRD is necessary for early detection.
