Paediatric retinal detachments: clinical characteristics and surgical outcomes

Abstract

Abstract Purpose To evaluate the clinical characteristics and surgical outcomes of paediatric retinal detachment in an Asian population. Methods A retrospective case series of all patients aged 18 years and under who underwent retinal detachment surgery at the Singapore National Eye Centre from 1994 to 2008. Results 133 eyes in 116 patients were treated for retinal detachment over 15 years. 88 patients (75.9%) were male. The mean age was 14.0 years (range 3 to 18 years; median 15 years). Retinal detachment was caused by trauma in 13.5% (18 eyes). Myopia was the most common risk factor, present in 57 eyes (42.9%). 9% (12 eyes) had pseudophakic retinal detachment and 3.0% (4 eyes) had aphakic retinal detachment. The mean duration from onset of symptoms to presentation was 43 days (+/‐92.4). Initial visual acuity (VA) was 6/12 or better in 19.5% of eyes, while 53.9% of eyes had VA worse than 6/60 at presentation. The macula was still attached in only 22.1% of eyes. 85% of eyes had one retinal detachment surgery performed. 74% of our patients were treated with a sclera buckling procedure at the first instance. 18.3% had a combined vitrectomy with sclera buckling. Only 7.6% had primary vitrectomy as the initial treatment. 85% (113) of eyes achieved anatomical success defined by a completely attached retina on last followup, at least 6 months after last surgical procedure. 43.7% of eyes achieved a final postoperative VA of 6/12 or better. 76.2% of eyes had VA 6/60 or better. Conclusion Paediatric retinal detachments are characterised by delayed diagnosis, high incidence of macular involvement on presentation and a male predominance. In our series, myopia was the most common risk factor, which is not unexpected given the high incidence of childhood myopia in our population.