Clinical profile and outcomes of rhegmatogenous retinal detachment related to trauma in pediatric population

Abstract

ObjectiveTo analyze the outcomes of trauma-related rhegmatogenous retinal detachment (RD) in pediatric population. DesignRetrospective observational series. ParticipantsAll patients under 18 years of age who underwent surgery for RD following trauma from 2010 to 2018. MethodsData were recorded from medical records regarding type of trauma, ocular status at presentation, details of RD (extent, number of breaks, proliferative vitreoretinopathy, choroidal detachment). The surgical intervention (scleral buckling or vitrectomy; tamponade used) and postoperative outcomes, including anatomical success, resurgeries, and visual acuity, were noted. ResultsWe included 32 eyes of 32 patients, where closed globe injury was seen in 13 eyes (41%) and open globe injury (OGI) in 19 eyes (59%). At presentation, 50% of the eyes had RD, with total RD in 20 eyes (63%). Scleral buckling was performed in 9 eyes (28%), whereas the remainder (n = 23) underwent pars plana vitrectomy with silicon oil tamponade for RD repair. Silicone oil removal was done in 16 eyes (70%) and recurrent or persistent RD was seen 17 eyes (53%). Final reattachment rate was 75% (n = 24). The final best-corrected visual acuity was better in the closed globe injury group (mean = 5/60 Snellen's vs 1/60 Snellen's in OGI group), though this was only marginally significant statistically. Late complications were seen in 26 eyes (81%), of which 18 (69%) had previous OGI. ConclusionPediatric traumatic RDs have very poor anatomical and visual outcomes. OGI fares worse than closed globe. Loss of vision in children can be prevented by better safety measures so as to avoid trauma.