Purpose To report the clinical features and surgical and visual outcomes of rhegmatogenous retinal detachment (RRD) in the paediatric population. Methods A retrospective review of children (aged 0-15 years) who underwent primary surgical repair for RRD at the Hiroshima University Hospital between 1988 and 2001. Results In all 53 eyes of 49 patients were identified; paediatric RRD accounted for 3.1% of 1779 eyes with RRD operated on during this period. The causes of RRD included blunt trauma (27%), myopia (25%), idiopathic (20%), familial exudative vitreoretinopathy (13%), and others. Among 55 eyes, 12 (22%) already had proliferative vitreoretinopathy (PVR) of grade C or D preoperatively. The median initial visual acuity (VA) was 0.3. Retinal reattachment was achieved with a single operation in 78%. Final retinal reattachment was achieved in 87%. Retinal reattachment rates with and without PVR were 42% and 100%, respectively (Po0.01). Median final VA was 0.7. Final VA was X0.1 in 73% and X0.5 in 53%; four eyes had a final VA of no light perception. The presence of preoperative PVR (P ¼ 0.03) and the initial VA (Po0.0001) significantly affected final VA. Conclusions Paediatric RRD is characterised by a delay in diagnosis, as evidenced by the high rate of PVR at presentation. Retinal reattachment was adversely affected by the presence of PVR. Final VA correlated with the initial VA and was significantly affected by preoperative PVR. Early diagnosis may improve the visual prognosis of paediatric retinal detachment.

It is suggested that osteopontin may promote osteoclast binding to resorptive sites by interacting with the alphavbeta3 receptor on osteoclasts. However, the role of osteopontin in functional remodeling of bony structures remains unclear. The present study was conducted to examine the distribution of osteopontin on the condyle and explore the role in condylar remodeling in growing rats using an immunohistochemical method. Twenty Wistar strain male rats aged 7, 14, 28 and 56 days were used. In 7- and 14-day-old rats, no immunoreaction to osteopontin was detected in the cartilage cells. In 28-day-old rats initiating mastication, the thickness of condylar cartilage was decreased abruptly as compared to the younger rats. High immunoreaction to osteopontin was found in the cytoplasm of hypertrophic chondrocytes and on the trabecular bone surfaces of primary spongiosa adjacent to the osteoclasts or chondroclasts. The immunoreactions to osteopontin in the cytoplasm of hypertrophic chondrocytes were less in 56-day-old rats than in 28-day-old rats. It is shown that the alteration in mechanical loading on the mandibular condyle due to functional changes from weaning to mastication correlates with the localization of osteopontin in growing rats. Furthermore, it is suggested that osteopontin may stimulate osteoclastic resorption of calcified matrix by mediating the attachment of osteoclasts and/or chondroclasts during growth-related functional remodeling of the condyle.

These findings suggest that the level of Pyr and the Pyr/Dpyr ratio in urine may be a useful diagnostic indicator for intra-articular pathologic changes during TMJ OA.

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