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Paediatric retinal detachment: comparison of high myopia and extreme myopia
1Department of Ophthalmology, Chang Gung Memorial Hospital, Linkuo, Taiwan.
Insights
Paediatric retinal detachment (RD) in extreme myopia has poorer surgical outcomes than in high myopia. Higher refractive error predicts worse surgical success, suggesting distinct management approaches are needed.
Area of Science:
- Ophthalmology
- Paediatric Ophthalmology
- Retinal Surgery
Background:
- Paediatric retinal detachment (RD) is a significant cause of vision loss in children.
- High myopia and extreme myopia present distinct challenges in managing RD.
- Understanding differences in clinical features and surgical outcomes is crucial for effective treatment.
Purpose of the Study:
- To compare the clinical features and surgical outcomes of paediatric RD in high myopia versus extreme myopia.
- To identify predictors of surgical success in paediatric RD.
Main Methods:
- Retrospective review of 107 children with RD and spherical equivalent (SE) of at least -6.00 dioptres (D).
- Patients categorized into high myopia (SE -6.0 to -10.0 D) and extreme myopia (SE >-10.0 D) groups.
- Comparison of RD characteristics, surgical procedures, and outcomes between groups.
Main Results:
- Significant differences observed in total RD, posterior staphyloma, and break types between groups (p<0.001).
- Extreme myopia group required more vitrectomies post-initial repair.
- Retinal reattachment rates were 97.5% in high myopia vs. 73.3% in extreme myopia.
- Higher refractive error was the sole negative predictor of surgical outcome (p=0.026).
Conclusions:
- Paediatric RD in extreme myopia exhibits distinct clinical features and poorer surgical outcomes compared to high myopia.
- Management strategies for paediatric RD should be tailored based on myopia severity.
- Higher refractive error is associated with reduced surgical success in paediatric RD.
Aims:
To compare the clinical features and surgical outcomes of paediatric retinal detachment (RD) in high myopia and extreme myopia.
Methods:
The clinical charts of 107 children who experienced RD and had a spherical equivalent (SE) of at least 6.00 dioptres (D) were reviewed. The patients were separated into a high myopia group (SE -6.0 to -10.0 D) and extreme myopia group (SE >-10.0 D). RD characteristics and outcomes were compared between these two groups.
Results:
There were significant differences between the two groups in total RD (p<0.001), the presence of posterior staphyloma (p<0.001) and some types of breaks. More eyes in the extreme myopia group required vitrectomy after the initial RD repair. In the high myopia group, retinal reattachment was achieved in 79 eyes (97.5%) at the end of the intervention, whereas in the extreme myopia group, retinal reattachment was achieved in 22 eyes (73.3%). Multiple logistic regression showed that a higher refractive error was the only negative predictor of surgical outcome (p = 0.026).
Conclusion:
Due to differences in aetiologies, clinical characteristics, required surgical procedure after initial repair, surgical and functional outcomes, paediatric RD with extreme myopia should be addressed differently from paediatric RD with high myopia.
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