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  • Title: Clinical characteristics and surgical outcomes of pediatric rhegmatogenous retinal detachment in Taiwan.
    Author: Chang PY, Yang CM, Yang CH, Huang JS, Ho TC, Lin CP, Chen MS, Chen LJ, Wang JY.
    Journal: Am J Ophthalmol; 2005 Jun; 139(6):1067-72. PubMed ID: 15953438.
    Abstract:
    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.
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