Pediatric retinal detachment repair yields favorable outcomes vs. no intervention
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Key takeaways:
- Prior ocular surgery was the most common predisposing condition to pediatric retinal detachments.
- Most cases presented with the fovea detached.
CARLSBAD, Calif. — Retinal detachment repair in pediatric patients yielded favorable anatomic and visual outcomes compared with no intervention, according to a poster presented at the Women in Ophthalmology Summer Symposium.
“Retinal detachments in children can result in lifelong consequences, including amblyopia, loss of stereopsis, limitations of future career choices, mild to severe disability and loss of independence, and worse quality of life,” S. Tammy Hsu, MD, of the department of ophthalmology at Duke University School of Medicine, and colleagues wrote.
To quantify and examine characteristics and outcomes of pediatric retinal detachment repair, Hsu and colleagues conducted a retrospective chart review of 172 patients aged 18 years and younger (mean age, 10 years; 68.6% male; 52.9% white) in the Duke University Health System database who underwent primary retinal detachment repair between 2012 and 2022. Multivariable regression identified factors associated with surgical success, which was defined as sustained foveal attachment, and final best corrected visual acuity. The mean duration of follow-up was 3 years.
Overall, 187 pediatric eyes with retinal detachments were included in the review. Of those, 71.7% showed unilateral involvement, 64.7% had rhegmatogenous retinal detachment, and 76.5% presented with the fovea detached.
Predisposing conditions included prior ocular surgery (36.9%), eye trauma (31%), high myopia (24%), Stickler syndrome (13.9%) and history of retinopathy of prematurity (12%).
The single-surgery success rate was 76%. Factors associated with surgical success included rhegmatogenous retinal detachment, absence of proliferative vitreoretinopathy, scleral buckle and gas/oil tamponade.
Mean final BCVA was 20/400 and mean improvement in BCVA was three lines in eyes with sustained foveal attachment after surgery.
Additionally, final BCVA was worse in eyes that had worse initial BCVA and if a retinectomy was needed.
“Despite the complexity and lower initial reattachment rate compared to adult retinal detachments, the overall anatomic and visual outcomes for retinal detachment repair in pediatric patients are still favorable as opposed to if no intervention were undertaken,” the researchers wrote.
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Hsu ST, et al. Analysis of pediatric retinal detachment repair outcomes at a single tertiary care center. Presented at: Women in Ophthalmology Summer Symposium; Aug. 22-25, 2024; Carlsbad, California.
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