Clinical Presentations and Outcomes of Pediatric Rhegmatogenous Retinal Detachment: 11 Years' Experience at a Tertiary Eye Center

Abstract

Background and Objectives: Pediatric rhegmatogenous retinal detachment (RRD) represents a challenge for ophthalmologists and vitreoretinal surgeons. In this study, we aim to review the clinical features, and surgical and visual outcomes of pediatric RRD in a tertiary referral center. Materials and Methods: This is a retrospective study using the review of charts for all patients who presented to King Abdul-Aziz University Hospital, Riyadh, Saudi Arabia, from 2005 to 2016. This study included patients 18 years old or younger, had undergone surgical repairs for RRD, and were followed up for 1 year or more. Results: Eighty-nine eyes of 70 children who underwent surgical repair for RRD were included in the current retrospective study. A previous history of intraocular surgeries was present in 31.5%. The majority of cases had known ocular disease or syndromes (n = 58, 65.2%). The majority of eyes which had a primary surgical intervention achieved anatomical success (n = 88). Corneal complications accounted for the majority of complications following primary and secondary surgical interventions. Forty-two percent of the eyes had vision better than 20/200, while thirty-five percent had vision of hand motion or worse. Conclusions: In conclusion, despite the variability in causes of RRD in children, successful anatomical outcomes can be achieved with the proper surgical approach. Visual outcomes are less predictable due to other ocular complications.

Keywords: RD; outcome; pediatric rhegmatogenous retinal detachment; retinal detachment; vitrectomy.

Figure 1

Predisposing factors for pediatric RRD: This is a bar chart of the most common predisposing factors for pediatric rhegmatogenous retinal detachments (RRD) including high myopia, amblyopia treatment, previous intraocular surgery, cataract, congenital glaucoma, trauma, retinopathy of prematurity, open globe, previous history of retinal detachment, and family history of a congenital syndrome.

Figure 2

Retinal quadrants involved in the RRD. This is a pie chart showing the retinal quadrants involved in pediatric RRD which include superior, inferior, inferotemporal, superonasal and temporal quadrants of the retina.

Figure 3

Postoperative ocular complications. This is a bar chart which shows the ocular complications of the pediatric RRD repair including band keratopathy, corneal decompensation, corneal scar, phthisis bulbi, scleral buckle infection and removal, acquired aniridia or aphakia, hyphema, hypotony and PSCC.