Paediatric vs adult retinal detachment

Abstract

Objective To evaluate the causes, incidences, characteristics, and treatment outcomes of paediatric vs adult retinal detachment. Patients and methods One hundred and sixty (136 patients) out of 2408 consecutive retinal detachments (6.6%) at our facility occurred in children under the age of 18 years. Of them, 144 eyes (90%) of 127 (93%) children were treated and compared with a sample of 56 consecutive retinal detachments in 50 adults (over the age of 18 years). The parameters for comparison included cause, type of retinal detachment, its extent, macular involvement, number of tears, number and types of surgery, and the anatomic and functional surgical outcome. Results Statistically significant differences were found in the type of retinal detachment. Rhegmatogenous RD was less common (P ¼ 0.004), and exudative RD was more common (P ¼ 0.021) in the paediatric group. Ocular trauma and ocular syndromes were more common in the paediatric group (Po0.001), while myopia, posterior vitreous detachment, and retinal detachment following cataract surgery were less common in this group compared with adults (Po0.001, o0.001, and 0.001, respectively). Ocular pathologies associated with retinal detachment were more common in the paediatric group (Po0.001). Initial and last visual acuity of 420/400, last visual acuity of 420/40, and retinal complete reattachment were higher in adults (Po0.001). Conclusions The type of retinal detachment, causes and outcomes were statistically different between paediatric and adult cases. The less successful functional and anatomical outcomes of retinal detachment surgery in children may reflect the different aetiologies and indicate the need for aetiology-specific treatment strategies according to each aetiology.

Pediatric retinal detachment in the Eastern Province of Saudi Arabia: experience of a tertiary care hospital

“…Blunt trauma was the most notable cause of retinal detachment, responsible for 9/20 (45%) cases. This is higher than reported in other studies6 and may be due to a higher incidence of ocular trauma in Saudi Arabia 8. Myopia and vitreoretinal degeneration are more common in the Arabian population due to hereditary factors, and this was reflected in our study with 4/20 (20%) cases910 of retinal detachment associated with myopia.…”

“…This incidence is higher than reported in studies from other parts of the world. Yokoyama et al5 found an incidence of 3.1% of pediatric RRD (age 0-15 years; mean 12 years) of all RRD cases in the Japanese population, while Rumelt et al6 found an incidence of 6.6% (age 0-18 years; mean 10.8 years) in a mixed Middle Eastern population of mainly Caucasian descent. This higher incidence in our study may be related to factors such as a higher incidence of inherited myopia/vitreoretinal degeneration in children and ocular trauma in pediatric population due to socioeconomic factors in Saudi Arabia.…”

Evaluation and management of pediatric rhegmatogenous retinal detachment

“…Hence, children with retinal detachments are more likely to present with fluid under the macula and with proliferative vitreoretinopathy (PVR) ( Table 1). 6 Compared to the adult population, pediatric patients present with worse acuity, after greater delay, and with a higher percentage of macular involvement, 75-85% (Table 1) as opposed to about 50% in adults. 6 Due to delayed presentation as well as increased cellular activity and proliferation, a higher percentage of pediatric patients present with PVR.…”

“…6 Compared to the adult population, pediatric patients present with worse acuity, after greater delay, and with a higher percentage of macular involvement, 75-85% (Table 1) as opposed to about 50% in adults. 6 Due to delayed presentation as well as increased cellular activity and proliferation, a higher percentage of pediatric patients present with PVR. Between 20% and 60% of patients present with PVR grade C or worse (Table 1).…”

“…1 Pediatric RRD is much less common, with an annual incidence only 0.38-0.69 per 100,000, 2 making up only 0.5-8% of all retinal detachments. [2][3][4][5][6][7][8][9] A number of case series of pediatric RRD have been reported (Table 1). [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Most of these case series include patients up to 18 years of age and the mean or median ages of presentation that are reported are 9-13 years of age.…”