Clinical characteristics and surgical outcomes of pediatric rhegmatogenous retinal detachment

Abstract

The objective of this study was to analyze the characteristics and surgical results of pediatric rhegmatogenous retinal detachment (RRD). The medical records of 30 eyes of 29 patients younger than 18 years of age who underwent vitreoretinal surgery due to RRD were analyzed. The gender, age, laterality, duration of presenting symptom, etiology, ocular and systemic co-morbidities, type of breaks, lens status, presence of proliferative vitreoretinopathy (PVR) and its grade, initial and final best-corrected visual acuities (BCVAs), surgical management, number of operations, duration of follow-up, functional and anatomical success, and complications were noted. As the most common predisposing factors were trauma (trauma group) and myopia (myopia group), the data of these patients were further analyzed. The mean age was 12.6 ± 3.0 years. There were 23 male (79.3 %) and 6 female (20.6 %) subjects. The most common etiologic factors were high myopia (40 %) and trauma (36.6 %). Functional success rate was 70 % (n = 21) after the primary surgeries and was 80 % (n = 24) after the secondary surgeries. There were no significant differences between the trauma and myopia groups regarding the presence of total retinal detachment, macula-off status, and the rate of PVR worse than grade C. Although the preoperative mean BCVA and the initial and final retinal reattachment rates of the groups were statistically similar, trauma group had significantly higher postoperative mean BCVA compared to myopia group (p = 0.013). Myopia and trauma were the most common etiologic factors for RRD in children. The visual outcomes of trauma-associated RRD were better than those of myopia-associated RRD.

Clinical Features and Outcome of Paediatric Retinal Detachment

“…In our subgroup of RD in children with congenital or developmental ocular abnormalities, the mean age was significantly lower (7.3 years, SD 5.9). Consistent with other reports, we found a strong male predominance (77%) [1,4,7,14,[16][17][18] . In the trauma group, the percentage of boys was even higher (87%).…”

“…RD in children commonly occurs in early puberty [4] . Similar to our data, other authors reported a mean age between 8.3 and 12.5 years [8,14,16,17] . In our subgroup of RD in children with congenital or developmental ocular abnormalities, the mean age was significantly lower (7.3 years, SD 5.9).…”

“…As stated in previous papers, this fact is very likely associated with the different playing habits and increased adventurous behaviour of boys compared to girls [10,12,19] . Regarding clinical symptoms, as in our study impaired VA is generally the most frequent presenting symptom [5,9,17] . However, a large percentage of children (42%) tend to be diagnosed with RD in the absence of any symptoms, which can be explained by their inability to interpret and communicate visual impairment [17] .…”

“…Regarding clinical symptoms, as in our study impaired VA is generally the most frequent presenting symptom [5,9,17] . However, a large percentage of children (42%) tend to be diagnosed with RD in the absence of any symptoms, which can be explained by their inability to interpret and communicate visual impairment [17] .…”

“…Vitrectomy is usually more difficult to conduct in children because of the usually attached vitreous in children and a strong vitreous adherence at the posterior pole [2,11,13] . However, ppV is favourable in patients with complex RD, presence of PVR and difficult preoperative break localisation [16,17] . Similar to our data, recent reports have shown a tendency to a much higher percentage of ppV as a first surgical method [13,17,21] than earlier reports [8,17] .…”