[Retinal detachment in children and adolescents. Specific clinical features]

Area of Science:

• Ophthalmology
• Pediatric Medicine
• Retinal Diseases

Background:

• Retinal detachment poses a significant threat to vision in children and adolescents due to increased life expectancy.
• This study focuses on the unique clinical features of retinal detachment in individuals up to 20 years of age.

Purpose of the Study:

• To analyze the clinical characteristics of retinal detachment in pediatric and adolescent populations.
• To identify specific patterns and challenges in diagnosing and managing juvenile retinal detachment.

Main Methods:

• Retrospective analysis of 259 patients diagnosed with retinal detachment before age 20.
• Inclusion criteria: unilateral or bilateral detachment, first diagnosis before 20, at least one surgery.
• Data collected on clinical features of the initial retinal detachment in the affected eye.

Main Results:

• Average delay between symptoms and diagnosis was 9.6 weeks; vision loss was the most common symptom (36.3%).
• Retinal detachment was often discovered incidentally (40.2%), with 2-quadrant detachment (34.0%) and macular involvement (59.5%) being frequent.
• Common break types included tears near the ora serrata (36.1%), giant tears (12.8%), and multiple holes; 22.4% had no identifiable break intraoperatively. Primary proliferative vitreoretinopathy (PVR) stage C or higher was present in 25.5%.

Conclusions:

• Delayed diagnosis in pediatric and adolescent retinal detachment leads to extensive detachment, frequent macular involvement, and high rates of severe primary PVR.
• Characteristic features of juvenile retinal detachment include ora serrata tears, giant tears, multiple equatorial holes, and a high incidence of undetectable breaks.