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Contemporary Patterns and Underlying Causes of Vitrectomy in Pediatric and Adolescent Patients: A Nationwide,
Ju-Yeun Lee1, Kyungsik Kim2, Kunho Bae3
1From the Department of Ophthalmology (J.Y.L.), Myongji Hospital, Hanyang University College of Medicine, Goyang, South Korea; Department of Preventive Medicine (J.Y.L., K.K., K.B.), Seoul National University College of Medicine, Seoul, South Korea; Integrated Major in Innovative Medical Science (J.Y.L.), Seoul National University College of Medicine, Seoul, South Korea.
Insights
Pars plana vitrectomy (PPV) incidence in pediatric and adolescent populations varies by sex and age, with declining trends in adolescents. Etiologies differ, necessitating tailored patient education and examination.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Public Health
Background:
- Vitreoretinal diseases requiring pars plana vitrectomy (PPV) impact pediatric and adolescent populations.
- Understanding the epidemiology of PPV in young individuals is crucial for effective management and resource allocation.
Purpose of the Study:
- To determine the incidence, etiology, and longitudinal trends of vitreoretinal diseases necessitating PPV in pediatric and adolescent populations.
- To analyze demographic variations in PPV rates and underlying causes.
Main Methods:
- A nationwide, population-based cohort study using the Korean National Health Claims database (2009-2020).
- Inclusion of all pediatric and adolescent patients (<20 years) who underwent PPV.
- Estimation of cumulative incidence, annual trends, etiology proportions, and comorbidities based on sex and age groups.
Main Results:
- 1913 patients underwent PPV; cumulative incidence was 21.42 per 100,000.
- PPV rates were 2.4 times higher in males; trauma comorbidity was also higher in males.
- Retinopathy of prematurity (ROP) was the primary etiology in infants (72%), while retinal detachment (RD) was most common in older individuals (63%).
- Myopia (30.3%) and atopic dermatitis (31.8%) were common comorbidities.
Conclusions:
- Primary etiologies for PPV in pediatric and adolescent populations differ by sex and age.
- PPV incidence shows a declining trend in the adolescent population.
- Tailored patient education and age-specific etiological examinations are recommended.
Purpose:
We determined the incidence, etiology, and longitudinal trends of vitreoretinal diseases necessitating pars plana vitrectomy (PPV) in the pediatric and adolescent population.
Design:
Nationwide, population-based cohort study.
Methods:
This study utilized data extracted from the Korean National Health Claims database spanning from 2009 to 2020. All pediatric and adolescent patients (under 20 years of age) who underwent PPV across the Korean population were included. The cumulative incidence of PPV was estimated from 2009 to 2020, with 2009 to 2011 as the washout period. The annual trends of PPV incidence, the proportion of each etiology, and comorbidity were estimated based on sex and specific age groups.
Results:
In total, 1913 patients, including 83 infants, 746 pediatric patients, and 1084 adolescents, were newly identified as having undergone PPV surgery. The cumulative incidence of PPV surgery per 100,000 individuals was 21.42 (95% CI, 21.41-21.43). The rate of PPV was 2.4 times higher for males than females, and the rate of trauma as a comorbidity was also higher for males than females (13.1% vs 4.8%). Among males aged 5 years and older, the incidence of PPV nearly halved from 2011 to 2020. Among the primary etiologies, ROP had the highest rate (72%) in infants (under 1 year), while RD was most common (63%) in individuals aged 5 to 19 years. Myopia was present in 30.3% of patients, and atopic dermatitis was present in 31.8% of all patients.
Conclusion:
The primary etiologies underlying the need for PPV in the pediatric and adolescent populations vary by sex and age group. The incidence of PPV continues to decline in the adolescent population. Therefore, tailored patient education and age-specific etiological examination are recommended.
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