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Published on: September 11, 2013
IMPACT OF ETIOLOGY ON THE OUTCOME OF PEDIATRIC RHEGMATOGENOUS RETINAL DETACHMENT
Ying-Chen Huang1,2, Yen-Chang Chu1,2, Nan-Kai Wang1,2
1Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Insights
Pediatric rhegmatogenous retinal detachment is often caused by myopia or congenital/developmental diseases. Congenital/developmental conditions independently predict poorer outcomes, while myopia is linked to better reattachment rates.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Pediatric Eye Care
Background:
- Rhegmatogenous retinal detachment (RRD) in children is less common than in adults.
- Etiologies and prognostic factors for pediatric RRD require further elucidation.
Purpose of the Study:
- To assess clinical features and surgical outcomes of pediatric RRD.
- To determine the independent impact of various etiologies on surgical results.
Main Methods:
- Retrospective review of 86 pediatric patients (<18 years) undergoing vitreoretinal surgery (2008-2013).
- Classification of RRD cases by etiology.
- Multivariate logistic regression to analyze outcome associations with etiologic factors.
Main Results:
- Myopia (55.8%) and congenital/developmental diseases (39.5%) were leading causes of pediatric RRD.
- Congenital/developmental diseases were associated with the worst functional outcomes (P=0.006).
- Myopia predicted better retinal reattachment rates (P=0.030) and had the lowest surgical failure rate (8.08%).
Conclusions:
- Myopia and congenital/developmental diseases are primary causes of pediatric RRD.
- Etiology significantly influences surgical outcomes in pediatric RRD.
- Congenital/developmental diseases are independent predictors of poor surgical response.
Purpose:
To evaluate the clinical features and surgical outcomes of rhegmatogenous retinal detachment in pediatric patients and to identify the independent effect of each etiology on the outcome.
Methods:
A review of patients younger than 18 years who underwent vitreoretinal surgery was conducted at Chang Gung Memorial Hospital, Taoyuan, between 2008 and 2013. Patients were classified according to etiology. Multivariate logistic regression analysis was performed to evaluate the association between outcomes and each etiologic factor.
Results:
A total of 86 cases (mean age: 12.9 ± 4.8 years; 76.7% male) were included. The mean follow-up was 46.3 ± 23.9 months. In 90.7% of patients, at least one etiology could be identified, including myopia (55.8%), congenital or developmental disease (39.5%), trauma (27.9%), and previous intraocular surgery (17.4%). Among the risk factors examined in this study, congenital or developmental disease had the worst functional outcomes (P = 0.006). Myopia was a good prognostic factor for a better retinal reattachment rate (P = 0.030). Myopic rhegmatogenous retinal detachment had the lowest probability of surgical failure (8.08%), and idiopathic rhegmatogenous retinal detachment had the lowest likelihood of postoperative visual decline (4.65%).
Conclusion:
Myopia and congenital or developmental disease are the leading etiologies of pediatric rhegmatogenous retinal detachment. Different etiologies are associated with distinctive outcomes, and congenital and developmental diseases are independent prognostic factors of a poor response.
