Abstract
Purpose :
Pediatric rhegmatogenous retinal detachments (RRD) make up a small percentage of all retinal detachments and typically present late with poor visual outcomes. We performed a retrospective clinical study to better characterize the predisposing factors, clinical course, surgical methods, and outcomes of pediatric RRD at a major children’s hospital in Dallas.
Methods :
We performed an IRB-approved, retrospective review of data for patients under 18 years old who underwent surgical repair for RRD from January 1, 2004 to December 31, 2019. Exclusion criteria included a history of retinoblastoma, the presence of persistent fetal vasculature or active retinopathy of prematurity, and those who had follow-up of less than 6 months. Patient’s age, race, gender, laterality, etiology, risk factors, presenting symptoms, fellow eye findings, exam findings at diagnosis, type and location of break, presence or absence of proliferative vitreoretinopathy (PVR), surgical procedures, post-op complications, initial and final best corrected visual acuities, and anatomic success were recorded.
Results :
A total of 93 eyes of 87 patients were included. The majority of the patients were male (n = 65; 74.7%) and the median age was 11 (+/- 4.25) years. 90.3% of eyes had at least one predisposing factor of pediatric RRD, including prior ocular surgery (n = 49, 52.7%), trauma (n= 44, 47.3%), myopia (n=35, 37.6%), and congenital anomaly (n=19, 20.4%). 58% of eyes had greater than one predisposing factor. 78.4% (n=73) had macula-off detachments and 36.6% (n=34) had PVR grade C or worse at the time of presentation. 52.7% (n=49) achieved anatomic success after the first operation. Overall, 71.0% (n=66) achieved anatomic success after their final surgery.
Conclusions :
The majority of the cases of pediatric RRD in this study are associated with the risk factors of congenital/developmental anomalies, myopia, trauma, or previous ocular surgery. Pediatric patients with RRD often present late as shown by the high incidence of macula-off detachments, as well as the presence PVR Grade C or worse. The majority of patients were able to achieve anatomic success after surgical repair using scleral buckle and/or vitrectomy.
This is a 2021 ARVO Annual Meeting abstract.