Characteristics and Surgical Outcomes of Pediatric Retinal Detachment

Abstract

Abstract: : Purpose: To report the clinical features, surgical and visual outcomes of rhegmatogenous retinal detachment (RRD) in the pediatric population. Methods: A retrospective review of children (aged 0-15 years) who underwent primary surgical repair for RRD in Hiroshima University Hospital between January 1988 and December 2000. Results: Fifty-five eyes of 49 patients were identified; pediatric RRD accounted for 3.2% of 1,705 eyes with RRD operated during this period. Median age was 12 years and 86% of patients were boys. Six (12%) patients had bilateral RRD at presentation. RRD etiologies included blunt trauma (27%), myopia (27%), familial exudative vitreoretopathy (13%), atopic dermatitis (9%), and others (24%). Among 55 eyes, 11 (20%) had already developed proliferative vitreoretinopathy (PVR) of grade C or D preoperatively. Median initial visual acuity (VA) was 0.3. Retinal reattachment was achieved by a single operation in 78%. Final retinal reattachment was achieved in 87% of eyes. Retinal reattachment rate without PVR and with PVR were 100% and 36%, respectively (p<0.001). Median final VA was 0.7. Final VA was ≥ 0.1 in 73% and ≥ 0.5 in 53%, with 4 eyes (7%) having a final VA of NLP. Final VA was correlated with initial VA (p<0.0001), and adversely affected by the presence of PVR (p=0.03). Conclusions: Pediatric RRD is characterized by a delay in diagnosis evidenced by its high rate of PVR at presentation. Retinal reattachment was adversely affected by the presence of PVR. Final VA was correlated with initial VA and adversely affected by the presence of PVR.

Keywords: retinal detachment • vitreoretinal surgery • clinical (human) or epidemiologic studies: out