Pediatric retinal detachments in eyes with extreme high myopia: Presenting features and final outcomes

Area of Science:

• Ophthalmology
• Retinal Diseases
• Pediatric Eye Care

Background:

• Extreme high myopia involves significant eye elongation, leading to structural changes like choroidal thinning and macular atrophy.
• These ocular changes increase susceptibility to complex retinal detachments (RD).

Observation:

• This case series details four pediatric patients with extreme high myopia ( -8.0 D to -16.0 D) presenting with RD.
• Presenting symptoms included squinting or abnormal pupillary reflex.
• Two patients had choroidal detachment, and two had macular holes causing RD.

Findings:

• All four pediatric patients required multiple surgical interventions.
• Anatomical success was achieved in three cases.
• Despite surgical efforts, final visual acuity was no perception of light in all four eyes.

Implications:

• Pediatric RD in the context of extreme high myopia presents significant surgical challenges.
• While anatomical restoration is possible, functional visual outcomes remain profoundly poor.
• This highlights the need for novel therapeutic strategies for this vulnerable patient group.