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Pediatric rhegmatogenous retinal detachment: clinical features and surgical outcomes
Christine R Gonzales1, Surjeet Singh, Fei Yu
1UCLA Jules Stein Eye Institute, David Geffen School of Medicine, Department of Ophthalmology, Los Angeles, CA, USA. Gonzales@jsei.ucla.edu
Insights
Pediatric rhegmatogenous retinal detachment (RRD) often has predisposing factors. Surgical outcomes can be favorable, but careful monitoring of the fellow eye is crucial due to common vision-threatening lesions.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Primary pediatric rhegmatogenous retinal detachment (RRD) is a rare but serious condition.
- Understanding its characteristics and surgical outcomes is vital for improving patient care.
Purpose of the Study:
- To describe the characteristics of primary pediatric RRD.
- To evaluate surgical outcomes and identify factors influencing anatomical success.
Main Methods:
- Retrospective study of pediatric patients (≤18 years) undergoing surgery for RRD over 5 years.
- Exclusion of recurrent RRD and active retinopathy of prematurity.
Main Results:
- Forty-six eyes of 45 patients included; median age 9 years.
- Predisposing factors present in 98% (prior surgery, trauma, developmental abnormality, myopia).
- Retinal reattachment achieved in 78%; younger age, worse initial vision, greater detachment extent, and proliferative vitreoretinopathy correlated with poorer outcomes.
Conclusions:
- Pediatric RRD frequently involves predisposing factors.
- Favorable anatomical and visual outcomes are achievable with surgery.
- High prevalence of vision-threatening lesions in the fellow eye necessitates vigilant follow-up.
Objective:
To describe the characteristics of and surgical outcomes for primary pediatric rhegmatogenous retinal detachment (RRD) and to evaluate whether specific characteristics impact anatomical outcomes after surgical intervention.
Methods:
Data for consecutive patients (18 years of age or younger) with RRD who required surgery over a 5-year period were studied retrospectively. Patients with recurrent retinal detachment or active retinopathy of prematurity were excluded.
Results:
Forty-six eyes of 45 patients (median age, 9 years) were included. Ninety-eight percent of the patients had at least 1 predisposing factor, including prior surgery (61%), trauma (43%), developmental abnormality (35%), and myopia (17%). Retinal reattachment was attained in 78% of eyes. Younger age (P = 0.019), worse initial vision (P = 0.008), greater extent of retinal detachment (P = 0.007), and presence of proliferative vitreoretinopathy (grade C or worse) (P = 0.008) were associated with worse anatomical outcomes. Vision improved after surgery in 56% of patients, but overall visual results were modest. Thirty-seven percent of patients had vision-threatening lesions in the other eye, and 18% had a history of retinal detachment in the fellow eye.
Conclusions:
Pediatric RRD is often associated with a predisposing factor. Favorable anatomical and visual outcomes are possible, and lesions in the fellow eye are common.
