Clinical Characteristics and Surgical Outcomes of Pediatric Rhegmatogenous Retinal Detachment in Taiwan

Abstract

To evaluate the clinical features and surgical and visual outcomes of rhegmatogenous retinal detachment (RRD) in the pediatric population. Retrospective, noncomparative, interventional case series. A review of patients under 18 years who underwent primary retinal detachment surgery at National Taiwan University Hospital from 1989 to 2003 was conducted. Included in the study were 152 eyes of 146 patients (mean age of 13.1 years). Male patients comprised 69.9% of the sample. Bilateral RRD was present in 4.1%. Etiologies included myopia >4 diopters (37.5%), trauma (32.9%), developmental anomaly (11.8%), previous surgery (5.9%), previous uveitis (3.9%), atopic dermatitis (2.6%), and unknown (5.3%). Macular detachment was found in 73.0%. The most common primary treatment was scleral buckling (61.2%). Single-operation reattachment was accomplished in 58.5% of patients and eventual reattachment in 78.3% of patients occurring in a mean of 1.5 (SD = 0.9) operations. Average postoperative follow-up time was 48.3 months. Visual improvement occurred in 42.8%, remained the same in 32.2%, and worsened in 19.1%. In the logistic regression model, statistically significant risk factors for poor surgical outcome were nonmyopic RRD (P = .026), macular involvement (P = .01), and presence of proliferative vitreoretinopathy (P = .07). Myopia >4 diopters was the most common etiology in retinal detachment in our sample, followed by trauma. Myopia (> -4.0 diopters) may be more common than previously reported. Most eyes (78.3%) were anatomically reattached after multiple surgeries. Retinal detachment not associated with myopia is a newly identified predictor for poor surgical outcomes.