Demography, clinical profile and surgical outcomes of paediatric giant retinal tear related retinal detachments

Abstract

Objective To determine the demographic profile, clinical features and surgical outcomes of giant retinal tear (GRT) related retinal detachments (RD) in children. Methods In this retrospective study, medical records of children aged 14 years and below, who underwent surgery for RD at our centre in the last 5 years were reviewed. Among these, we selected medical records of children with RDs with GRT, and examined the coloured retinal drawings, ultrawidefield photographs and/or surgical videos. Results Out of 1536 medical records, 91 eyes of 87 children (5.6% of all RDs) were included. Mean age was 10.21 ± 3.08 years with male:female ratio of 8.6:1. The most common aetiologies for GRTs were high myopia (28 cases-32.18%) and trauma (25 cases-28.73%). Bilateral RD were possibly present in 29/87 (33.3%) cases. Six months follow up data was available for 82/91 eyes. Overall retinal re-attachment was achieved in 52/82 (63.41%) eyes; in 33/82 (40.24%) eyes retinal attachment could be achieved by a single surgery.

Vitreoretinopathy-Associated Pediatric Retinal Detachment Treatment Outcomes

“…In our population, the mean age at first detachment was 10.4 years in the overall cohort, comparable with reports in the literature. 9 , 10 , 23 In the data presented here, the difference in sex was still skewed toward boys (57.9%) but not as prominently as seen in the literature (70%–80%). 2 , 9 The more equal distribution is perhaps due to the exclusion of traumatic RDs from our study.…”

Giant Retinal Tear Detachment

“…This is comparable with the previously reported literature showing poor anatomical and functional outcomes in pediatric cases attributed to preoperative risk factors. 34,35 Ours is a retrospective case series with the inherent limitations of a lack of a standardized surgical approach and follow-up because these decisions were patientspecific and left to the discretion of the consulting surgeon. Being a tertiary care referral center, a significant proportion included GRTD .180°with advanced PVR, contributing to poorer prognosis in such cases.…”

“…This is comparable with the previously reported literature showing poor anatomical and functional outcomes in pediatric cases attributed to preoperative risk factors. 34,35…”

Giant Retinal Tears: A Review With a Focus on Trauma

“…4,5 In children, GRTs are a more common cause of rhegmatogenous RDs, with one study finding that 5.6% of detachments were secondary to GRTs. 6 Patients with GRTs are predominantly male (55% to 91%) in most studies although one larger study reported a female predominance. [7][8][9][10][11] While ocular trauma has a significant male predominance and is the strongest risk factor for GRTs, the male predominance persists when traumatic GRTs are excluded.…”

“…A large, multicenter study of RDs showed that GRTs are more common in phakic eyes (2.9%) than in pseudophakic eyes (1.5%) 4,5 . In children, GRTs are a more common cause of rhegmatogenous RDs, with one study finding that 5.6% of detachments were secondary to GRTs 6 …”