Rhegmatogenous retinal detachments in children in India: clinical characteristics, risk factors, and surgical outcomes.
OBJECTIVE
To describe the spectrum of clinical features and surgical outcomes in children with rhegmatogenous retinal detachments in a tertiary-care hospital in northern India.


METHODS
In this retrospective interventional case series, 230 eyes of 216 children 18 years of age or younger undergoing surgery for rhegmatogenous retinal detachment were included. Detailed history and complete ophthalmic and systemic examination was performed when essential. Risk factors for retinal detachment were noted. Surgical intervention consisted of scleral buckling alone or standard 3-port pars plana vitrectomy with silicone oil tamponade. Rate of anatomical attachment and status of postoperative visual acuity were noted.


RESULTS
Mean age was 11.12 +/- 3.56 years. Most patients (81.9%) were boys. Thirty-five (16.2%) patients had bilateral retinal detachment at presentation. Detachments tended to be complex, with 54.3% (125/230 eyes) having some form of proliferative vitreoretinopathy. Mean follow-up was 12.3 months. Complete retinal reattachment was achieved in 88.7% of eyes; however, visual recovery was modest.


CONCLUSIONS
The most common conditions predisposing to rhegmatogenous retinal detachment were peripheral retinal degeneration and trauma. Rhegmatogenous retinal detachments secondary to iridofundal coloboma may be more common than previously reported. A combination of buckling and vitreoretinal techniques helped achieve retinal reattachment in most cases. The presence of anterior proliferative vitreoretinopathy is a poor prognostic factor in terms of both anatomic success as well as visual improvement.
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. drneerajwadhwa@gmail.com
Neeraj
N
Wadhwa
Pradeep
P
Venkatesh
Raju
R
Sampangi
Satpal
S
Garg
D000293:Adolescent; D002648:Child; D003103:Coloboma / Q000150:complications*; D005131:Eye Injuries / Q000150:complications; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D007194:India / Q000453:epidemiology; D007498:Iris / Q000002:abnormalities*; D008297:Male; D012160:Retina / Q000002:abnormalities*; D012162:Retinal Degeneration / Q000150:complications; D012163:Retinal Detachment / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D012167:Retinal Perforations / Q000150:complications*; D012189:Retrospective Studies; D012591:Scleral Buckling; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy; D018630:Vitreoretinopathy, Proliferative / Q000209:etiology