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Traumatic Retinal Detachment in Patients with Self-Injurious Behavior: An International Multicenter Study.

Elizabeth J Rossin1, Irena Tsui2, Sui Chien Wong3

  • 1Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.

Ophthalmology. Retina
|November 25, 2020
PubMed

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Summary
This summary is machine-generated.

Retinal detachment from self-injurious behavior (SIB) presents unique challenges. Surgical success rates are low, but scleral buckle use may improve outcomes for these complex cases.

Area of Science:

  • Ophthalmology
  • Retinal Surgery
  • Trauma Care

Background:

  • Self-injurious behavior (SIB) can lead to traumatic rhegmatogenous retinal detachment (RRD).
  • These cases present significant challenges due to patient cooperation, bilateral involvement, and ongoing trauma.
  • Understanding clinical characteristics and surgical outcomes is crucial for effective management.

Purpose of the Study:

  • To describe the clinical characteristics of patients with RRD secondary to SIB.
  • To evaluate surgical outcomes and success rates in this patient population.
  • To provide management recommendations for RRD resulting from SIB.

Main Methods:

  • Retrospective, international, multicenter interventional case series.
  • Review of clinical histories, surgical details, and follow-up findings from 78 patients (107 eyes).
Keywords:
PVR detachmentScleral buckleSelf-injurious behaviorTraumatic retinal detachment

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  • Analysis of single-surgery anatomic success (SSAS) and final retinal reattachment rates.

    • Main Results:

    • Fifty-four percent of patients had bilateral RRD or fellow eye phthisis bulbi.
    • The most common diagnoses included autism spectrum disorder and trisomy 21.
    • Single-surgery anatomic success (SSAS) was 23.1% without silicone oil tamponade; final reattachment was 80% with silicone oil. Scleral buckle use predicted better attachment rates.

    Conclusions:

    • RRD from SIB has low surgical success rates due to patient factors and ongoing trauma.
    • Scleral buckle (SB) use may be associated with improved outcomes.
    • Visual function can be restored in some patients, highlighting the need for tailored management strategies.