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IMPACT OF ETIOLOGY ON THE OUTCOME OF PEDIATRIC RHEGMATOGENOUS RETINAL DETACHMENT

Huang, Ying-Chen, MD*,†; Chu, Yen-Chang, MD*,†; Wang, Nan-Kai, MD, PhD*,†; Lai, Chi-Chun, MD*,†; Chen, Kuan-Jen, MD*,†; Hwang, Yih-Shiou, MD, PhD*,†; Wu, Wei-Chi, MD, PhD*,†

doi: 10.1097/IAE.0000000000001908
Original Study: PDF Only

Purpose: To evaluate the clinical features and surgical outcomes of rhegmatogenous retinal detachment in pediatric patients and to identify the independent effect of each etiology on the outcome.

Methods: A review of patients younger than 18 years who underwent vitreoretinal surgery was conducted at Chang Gung Memorial Hospital, Taoyuan, between 2008 and 2013. Patients were classified according to etiology. Multivariate logistic regression analysis was performed to evaluate the association between outcomes and each etiologic factor.

Results: A total of 86 cases (mean age: 12.9 ± 4.8 years; 76.7% male) were included. The mean follow-up was 46.3 ± 23.9 months. In 90.7% of patients, at least one etiology could be identified, including myopia (55.8%), congenital or developmental disease (39.5%), trauma (27.9%), and previous intraocular surgery (17.4%). Among the risk factors examined in this study, congenital or developmental disease had the worst functional outcomes (P = 0.006). Myopia was a good prognostic factor for a better retinal reattachment rate (P = 0.030). Myopic rhegmatogenous retinal detachment had the lowest probability of surgical failure (8.08%), and idiopathic rhegmatogenous retinal detachment had the lowest likelihood of postoperative visual decline (4.65%).

Conclusion: Myopia and congenital or developmental disease are the leading etiologies of pediatric rhegmatogenous retinal detachment. Different etiologies are associated with distinctive outcomes, and congenital and developmental diseases are independent prognostic factors of a poor response.

Myopia and congenital or developmental disease prevail among the etiologies of pediatric rhegmatogenous retinal detachment. Patients with congenital or developmental disease have the worst outcomes, and patients with myopia have the best outcomes.

*Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; and

College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Reprint requests: Wei-Chi Wu, MD, PhD, Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, 5 Fu-Hsin Road, Kweishan 333, Taoyuan, Taiwan; e-mail: weichi666@gmail.com

Supported by Chang Gung Memorial Hospital Research Grants (CMRPG3F0191∼3 and CMRPG3E0521∼-2) and by a National Science Council Research Grant (MOST104-2314-B-182A-100-MY2).

None of the authors has any conflicting interests to disclose.

Y.-C. Huang and Y.-C. Chu contributed equally to this study.

© 2018 by Ophthalmic Communications Society, Inc.