[Clinical features and surgical outcomes of children with rhegmatogenous retinal detachments].
OBJECTIVE
To describe the clinical features and surgical and visual outcomes in a series of children with rhegmatogenous retinal detachments (RRD).


METHODS
Retrospective case series of pediatric patients (14 years old or younger) with RRD who underwent primary surgery at a tertiary referral center between May 1995 and May 2006. Patients with perforating ocular trauma were excluded.


RESULTS
Thirty-six eyes of 33 patients were included in this study. The median age was 12 years, and 26 patients (78.8%) were male. Bilateral RRD was present in 10 patients (30.3%); 22 patients (66.7%) had some form of bilateral ocular pathology. At least one predisposing factor could be identified in 31 (86.1%) of eyes examined. Thirteen eyes (36.1%) experienced trauma, 11 eyes (30.6%) had structural abnormalities, high myopia and eyes underwent previous intraocular surgery were 7 (19.4%) each, and 3 eyes (8.3%) had inflammatory fundus disorders. Macular detachment was found in 28 eyes (77.8%). Median follow-up was 12 months. At the end of follow-up for this report, silicone oil was still in place in 4 eyes. Retinal reattachment was ultimately achieved in 29 of the 32 eyes (90.6%) with a mean of 1.9 surgeries per eye, however, visual recovery was modest. Predictors of a poor visual outcome were: hand motions or worse in preoperative vision (P = 0.001), macular-off retinal detachment (P = 0.003), proliferative vitreoretinopathy grade C or worse (P = 0.000), the need for vitrectomy surgery (P = 0.002), and the use of silicone oil (P = 0.005).


CONCLUSIONS
Trauma and congenital or developmental anomalies were the most common predisposing factors for pediatric RRD in this series. Retinal reattachment can be achieved in most cases with modern vitreoretinal surgical techniques. Predictors of visual outcomes are similar to those observed in adults. Regular follow-up for children at risk of developing RRD is necessary for early detection.
Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
Lüe
L
Li
Fang-tian
FT
Dong
Jun-jie
JJ
Ye
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D013508:Ophthalmologic Surgical Procedures; D012163:Retinal Detachment / Q000175:diagnosis* / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome