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Published on: September 11, 2013
[Pediatric Retinal Detachment]
1Klinik und Poliklinik für Augenheilkunde, Universität Leipzig.
Insights
Pediatric retinal detachment, accounting for 3-7% of cases, is often linked to trauma or genetic conditions. Outcomes are less successful than in adults, necessitating advanced surgical strategies.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
Background:
- Retinal detachment is significantly less common in children (3-7%) compared to adults.
- Key predisposing factors include trauma, myopia, hereditary vitreoretinopathies, retinopathy of prematurity, malformations, and Coats' disease.
Purpose of the Study:
- To review the etiology, surgical management, and outcomes of retinal detachment in pediatric patients.
- To highlight the need for improved treatment strategies for pediatric retinal detachment.
Main Methods:
- Review of existing literature on pediatric retinal detachment.
- Discussion of disease-specific surgical treatments, including episcleral buckling and vitrectomy.
- Evaluation of emerging treatments like intravitreal VEGF-inhibitors.
Main Results:
- Trauma-associated retinal detachment is most frequent in children.
- Vitreoretinopathies are the leading cause of inherited retinal detachment in this age group.
- Current functional and anatomical outcomes for pediatric retinal detachment are less favorable than in adults.
Conclusions:
- Episcleral buckling is preferred for clear-lens pediatric patients with peripheral tears.
- Primary vitrectomy is indicated for vitreoretinopathy.
- Further research on safety and efficacy of new treatments, alongside innovative surgical approaches, is crucial for improving outcomes in pediatric retinal detachment.
Abstract:
The number of retinal detachments in children is rarely compared to the number of retinal detachments in adults; only 3 - 7% occur in children. The main predisposing factors are trauma, myopia, hereditary vitreoretinopathies, retinopathy of prematurity, malformations and Coats' disease. The most frequent paediatric retinal detachments are trauma-associated and vitreoretinopathies are the most common cause of inherited retinal detachment. Disease-specific surgical treatments are discussed. Episcleral buckling surgery should be the preferred method in any case of clear lens, especially for treatment of oradialysis and well-defined localization of peripherally retinal tears. In those suffering from vitreoretinopathy, primary vitrectomy is necessary. The intravitreal use of VEGF-inhibitors to treat vasoproliferative retinopathy in children is a new and effective tool, but we need further results about safety and side-effects in young patients. The functional and anatomical outcomes of retinal detachment in children are less successful than in adults. Further surgical innovations and etiology-specific treatment strategies are required to improve the outcome in this group.
