Clinical characteristics and surgical outcomes of pediatric rhegmatogenous retinal detachment in Taiwan

Am J Ophthalmol. 2005 Jun;139(6):1067-72. doi: 10.1016/j.ajo.2005.01.027.


Purpose: To evaluate the clinical features and surgical and visual outcomes of rhegmatogenous retinal detachment (RRD) in the pediatric population.

Design: Retrospective, noncomparative, interventional case series.

Methods: A review of patients under 18 years who underwent primary retinal detachment surgery at National Taiwan University Hospital from 1989 to 2003 was conducted.

Results: Included in the study were 152 eyes of 146 patients (mean age of 13.1 years). Male patients comprised 69.9% of the sample. Bilateral RRD was present in 4.1%. Etiologies included myopia >4 diopters (37.5%), trauma (32.9%), developmental anomaly (11.8%), previous surgery (5.9%), previous uveitis (3.9%), atopic dermatitis (2.6%), and unknown (5.3%). Macular detachment was found in 73.0%. The most common primary treatment was scleral buckling (61.2%). Single-operation reattachment was accomplished in 58.5% of patients and eventual reattachment in 78.3% of patients occurring in a mean of 1.5 (SD = 0.9) operations. Average postoperative follow-up time was 48.3 months. Visual improvement occurred in 42.8%, remained the same in 32.2%, and worsened in 19.1%. In the logistic regression model, statistically significant risk factors for poor surgical outcome were nonmyopic RRD (P = .026), macular involvement (P = .01), and presence of proliferative vitreoretinopathy (P = .07).

Conclusions: Myopia >4 diopters was the most common etiology in retinal detachment in our sample, followed by trauma. Myopia (> -4.0 diopters) may be more common than previously reported. Most eyes (78.3%) were anatomically reattached after multiple surgeries. Retinal detachment not associated with myopia is a newly identified predictor for poor surgical outcomes.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Eye Injuries / complications
  • Female
  • Humans
  • Male
  • Myopia, Degenerative / complications
  • Prevalence
  • Retinal Detachment / epidemiology
  • Retinal Detachment / etiology*
  • Retinal Detachment / surgery*
  • Retrospective Studies
  • Scleral Buckling*
  • Taiwan / epidemiology
  • Treatment Outcome
  • Visual Acuity