Pediatric rhegmatogenous retinal detachment: A meta-analysis of clinical features, surgical success rate, and prognostic factors

Abstract

Pediatric rhegmatogenous retinal detachment (RRD) is an issue of debate regarding its surgical outcomes and prognosis because of diagnosis delay, more complex etiological factors, and a higher prevalence of postoperative complications. This meta-analysis aims to evaluate the anatomical and visual outcomes of pediatric RRD and the factors that influence the treatment results. This is the first meta-analysis on this subject. We searched the relevant publications in the electronic databases of PubMed, Scopus, and Google Scholar. Eligible studies were included in the analysis. Anatomical success after one surgery and the final rates of success were estimated. Subgroup analysis was performed to find the rate of success in patients with different prognostic factors. This meta-analysis showed that the total rate of success after one surgery was about 64%, which implies that performing the first surgery was enough to get anatomical reattachment in most of the patients. The final anatomical rate of success was about 84%. In terms of visual acuity, the pooled results revealed statistically significant ( P < 0.001) improvement in postoperative vision, with a 0.42 reduction in log of minimum angle of resolution (logMAR). The final rate of success was significantly lower in eyes with proliferative vitreoretinopathy (PVR) (about 25% lower in eyes with PVR, P < 0.001) and in the presence of congenital anomalies (about 36% lower in congenital cases, P = 0.008). Myopic RRD had a significantly better anatomical success rate. In conclusion, this study shows that there is a high chance of anatomical success after pediatric RRD treatment. The presence of PVR and congenital anomalies was associated with a poorer prognosis.

Risk factors and prognosis of pediatric rhegmatogenous retinal detachment in Egypt: a university hospital based study

“…Different types of retinal breaks can be found in eyes with pediatric RRD, including horseshoe tears, giant retinal tears, atrophic holes, and retinoschisis with ora serrata dialysis found more commonly in the pediatric age group in about 20%-42% [9] . In a previous study of pediatric RRD cases, a larger percentage of patients with dialysis had final reattachment compared to those with giant retinal tears and tractional retinal tears [11][12] . The surgical treatment approach is at the discretion of the surgeon based on certain findings of examination like PVR.…”

“…Additional challenges found in the pediatric age group are posed by the presence of systemic comorbidities as prematurity and connective tissue disorders, poor younger children cooperation during examinations, the difficulty with postoperative positioning, bilateral detachments, and a relatively high rate of trauma [6][7][8][9] . Despite the difficulty in managing these cases, successful reattachment of the retina is possible in the majority of cases [10][11][12][13] . While most retinal detachments in the adult population are related to myopia and posterior vitreous detachment (PVD), previous reports have highlighted the etiology in pediatric age group to be trauma, myopia, previous intraocular surgery and congenital or developmental anomalies being the most Int J Ophthalmol, Vol.…”

Paediatric optic pit‐associated macular detachment: A treatment strategy

“…Editor, Vitreoretinal surgery for paediatric retinal detachment (RD) poses significant challenges, given the multifactorial nature of paediatric RDs, which encompass congenital anomalies, hereditary conditions and acquired disorders (Abdi et al, 2023;Gan & Lam, 2018;Smith et al, 2019). Among the congenital anomalies implicated in RD pathogenesis, prominent entities include choroidal and lens coloboma, together with optic pit malformations.…”