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Howe Qiu, Nathan Fischer, Jennifer L Patnaik, Jennifer L Jung, Jasleen K Singh, Emily A McCourt; Pediatric Traumatic Cataract Complicated by Retinal Detachment. Invest. Ophthalmol. Vis. Sci. 2018;59(9):169. doi: https://doi.org/.
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Traumatic cataract in the pediatric population is a treatable cause of vision loss. In cases of simultaneous retinal detachment, the surgical approach may be different, and the prognosis for visual recovery is often poor. Our study investigates the risks for concurrent retinal detachment in patients with traumatic cataracts.
A retrospective review of patients diagnosed with traumatic cataract at Children’s Hospital Colorado between 2005 and 2014 was conducted. Demographics, mechanism of injury, and incidence of retinal detachment were recorded. Logistic modeling with generalized estimating equations to account for correlation between eyes was used to analyze associations between potential risk factors and retinal detachment.
Of 64 total eyes with traumatic cataract, 54 eyes presented with unilateral cataract and 5 pairs of eyes presented with bilateral cataracts. Mean patient age was 8.4 years (SD: 4.0, range 0-16) with 80% of patients identified as male. A total of 10 eyes (16%) were found to have comorbid retinal detachment, of which 3 eyes (30%) had penetrating trauma (2 by knife and 1 by plastic plate), and 7 eyes (70%) had non-penetrating trauma (6 by self-injurious hitting and 1 by unspecified blunt trauma). Traumatic cataracts caused by self-injurious behavior were more likely to present with simultaneous retinal detachment than traumatic cataracts caused by other mechanisms of injury, OR=2.8 (95%CI: 1.1-4.5, p=0.0010).
Patients presenting with traumatic cataract who display self-injurious behavior are at higher risk for concurrent retinal detachment. These patients are often difficult to examine in the office, and ocular ultrasound is sometimes unable to be performed until the patient is sedated in the operating room Thus, ophthalmologists should counsel the families of these high-risk patients and consider involvement of a retina specialist in surgical planning.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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