Rhegmatogenous retinal detachment in children 16 years of age or younger

Abstract

PurposeTo study the anatomical and visual outcomes and prognostic factors that may predict the outcomes of rhegmatogenous retinal detachment (RRD) in children.MethodsA retrospective chart review was performed for patients 16 years of age or younger who underwent retinal reattachment surgery for RRD at the King Abdulaziz University Hospital from 1996 to 2005 and the King Khalid Eye Specialist Hospital from 2002 to 2006, Riyadh, Saudi Arabia. Good visual outcome was defined as ≥20/200. The association between two categorical variables was evaluated with the Chi-squared test or the exact test, as appropriate. Predictors for RRD and good final visual acuity were identified by conducting stepwise logistic regression analysis. P < 0.05 was statistically significant.ResultsThe study population comprised 148 patients (166 eyes). There were 104 (70%) males and 44 (30%) females. Mean age at presentation was 8.33 ± 3.26 years (range 1.5–16 years). The retina was reattached after one surgical procedure in 106 (63.8%) eyes and reattached in 130 (78.3%) eyes after multiple surgeries. Factors predicting recurrence after the first surgery were myopia (P = 0.028), proliferative vitreoretinopathy (PVR) at presentation (P = 0.024), and total retinal detachment (P = 0.032). Good final visual outcome was achieved in 60 (44.4%) eyes. Predictors of good visual acuity were: good visual acuity at presentation (P < 0.001); absence of PVR at presentation (P < 0.001); one quadrant of retinal detachment (P = 0.0024); macula on (P = 0.0107); absence of primary repair of a ruptured globe (P = 0.0059); no pars plana vitrectomy (PPV) (P = 0.0123); clear phakic lens at follow-up (P < 0.001); absence of postoperative complications (P < 0.001); absence of recurrence of RRD (P < 0.001); and absence of epiretinal membrane (P = 0.0088). Logistic regression analysis indicated that recurrence of RRD was associated with myopia and previous congenital cataract surgery; good final visual outcome was associated with macula on detachment and poor visual outcome was associated with recurrence of RRD and occurrence of postoperative complications and previous repair of a ruptured globe.ConclusionRRD in children is usually associated with a predisposing factor, a high rate of PVR, and total retinal detachment. Despite late diagnosis and the presence of PVR, favorable anatomical and visual outcomes can be achieved.

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%).…”

“…The percentage of bilateral RD in non-traumatic cases ( n = 57) was 16%. In accordance with previous reports [18,21] , bilateral RD was mainly related to hereditary or developmental ocular disorders. The following underlying diseases were identified: high myopia, congenital cataract, vitreoretinal dysgenesis and FEVR.…”

“…Consistent with other reports [19] , RD associated with closed globe injury ( n = 24, 25%) was more common in our patient population than RD related to open globe injury ( n = 14, 15%). Our percentage of RD due to developmental abnormalities and previous surgical procedures was also concurrent with other publications [3,9,18,20] . Moreover, we noticed more traumatic cases in older children (71% of patients with traumatic RD were older than 10 years of age).…”

“…Our percentage of bilateral RD (9%) is lower than that in other publications [18,21] . This lower frequency could be related to the high percentage of traumatic cases usually affecting only 1 eye.…”

Pediatric Retinal Detachment in Indonesia: Clinical Characteristics, Risk Factors, and Treatment Outcomes

“…The prevalence of RD is reported as 12.4 cases per 100,000 in- dividuals, of which 3.2% -5.6% (0.38 -0.69 cases per 100,000 individuals) are of pediatric age [1] [2] [3] [4]. Management of pediatric RD remains challenging due to the viscosity of pediatric vitreous, the difficulty of scleral buckling in developing eyes, and the risk of proliferative retinopathy caused by a raised immune response [2] [3] [5].…”