Retinal detachment is rare in children, but when it does occur, doctors need to know how to discuss the prognosis with patients and their parents. A new Taiwanese study helps clarify the clinical features and surgical outcomes of rhegmatogenous retinal detachment (RRD) in pediatric patients.

In a review of 86 patients younger than 18 years (mean age: 12.9 ± 4.8; 76.7% male) who underwent vitreoretinal surgery between 2008 and 2013, researchers classified patients according to etiology and performed regression analysis to evaluate the association between outcomes and each etiologic factor. 

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. Myopia was a good prognostic factor for a better retinal reattachment rate. Myopic RRD had the lowest probability of surgical failure (8.08%) and idiopathic RRD had the lowest likelihood of post-op visual decline (4.65%).

Myopia and congenital or developmental disease are the leading etiologies of pediatric RRD, the authors noted. “Different etiologies are associated with distinctive outcomes, and congenital and developmental diseases are independent prognostic factors of a poor responss,” they wrote.

Huang Y, Chu Y, Wang N, et al. Impact of etiology on the outcome of pediatric rhegmatogenous retinal detachment. Retina. 2019;39:118–126.