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Review
. 2023 Mar;71(3):717-728.
doi: 10.4103/ijo.IJO_643_22.

Pediatric rhegmatogenous retinal detachment: A meta-analysis of clinical features, surgical success rate, and prognostic factors

Fatemeh Abdi  1 , Ali Aghajani  1 , Sara Hemmati  1 , Delaram Moosavi  1 , Arzhang Gordiz  1 , Samira Chaibakhsh  1 , Emad Soleimani Bayatiani  2
Affiliations
Review

Pediatric rhegmatogenous retinal detachment: A meta-analysis of clinical features, surgical success rate, and prognostic factors

Fatemeh Abdi et al. Indian J Ophthalmol. 2023 Mar.

Abstract

Pediatric rhegmatogenous retinal detachment (RRD) is an issue of debate regarding its surgical outcomes and prognosis because of diagnosis delay, more complex etiological factors, and a higher prevalence of postoperative complications. This meta-analysis aims to evaluate the anatomical and visual outcomes of pediatric RRD and the factors that influence the treatment results. This is the first meta-analysis on this subject. We searched the relevant publications in the electronic databases of PubMed, Scopus, and Google Scholar. Eligible studies were included in the analysis. Anatomical success after one surgery and the final rates of success were estimated. Subgroup analysis was performed to find the rate of success in patients with different prognostic factors. This meta-analysis showed that the total rate of success after one surgery was about 64%, which implies that performing the first surgery was enough to get anatomical reattachment in most of the patients. The final anatomical rate of success was about 84%. In terms of visual acuity, the pooled results revealed statistically significant (P < 0.001) improvement in postoperative vision, with a 0.42 reduction in log of minimum angle of resolution (logMAR). The final rate of success was significantly lower in eyes with proliferative vitreoretinopathy (PVR) (about 25% lower in eyes with PVR, P < 0.001) and in the presence of congenital anomalies (about 36% lower in congenital cases, P = 0.008). Myopic RRD had a significantly better anatomical success rate. In conclusion, this study shows that there is a high chance of anatomical success after pediatric RRD treatment. The presence of PVR and congenital anomalies was associated with a poorer prognosis.

Keywords: Meta-analysis; pediatric rhegmatogenous retinal detachment; proliferative vitreoretinopathy; rate of success; surgical success rate.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Flow diagram of studies assessed for the review
Figure 2
Figure 2
(a) Forest plot showing pooled primary rate of success per 100 patients based on 17 studies. (b) Forest plot showing pooled final rate of success per 100 patients based on 28 studies
Figure 3
Figure 3
The pooled rate differences in patients younger and older than 10 years
Figure 4
Figure 4
(a) The pooled rate differences in traumatic and nontraumatic RRD eyes. (b) The pooled rate differences in blunt and penetrating traumatic RRD eyes. (c) The pooled rate differences in myopic and nonmyopic RRD eyes. (d) The pooled rate differences in eyes with and without PVR. PVR = proliferative vitreoretinopathy, RRD = rhegmatogenous retinal detachment
Figure 5
Figure 5
The pooled rate differences in traumatic and myopic RRD eyes. RRD = rhegmatogenous retinal detachment
Figure 6
Figure 6
The comparison of visual acuity (mean of logMAR) pre- and postsurgery. logMAR = log of minimum angle of resolution
See this image and copyright information in PMC

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