Primary Diseases of 393 Cases of Pediatric Retinal Detachment and the Distribution of Clinical Characteristics

  Objective   To investigate the primary diseases and the distribution of the clinical characteristics of pediatric retinal detachment.

  Methods   Clinical records of patients aged 0-14 years old who had retinal detachment and who were hospitalized at the Department of Ophthalmology, West China Hospital, Sichuan University between January 2015 and December 2020, were retrospectively analyzed. The information on the demographic data, history, the scope of retinal detachment, and prognosis was retrieved and documented.

  Results   A total of 464 eyes of 393 patients were included in this study, including 261 male and 132 female patients at a ratio of 1.98:1. The most common type of primary disease causing pediatric retinal detachments was associated with ocular dysplasia (227 cases, 57.8%), followed by trauma (78 cases, 19.8%) and myopia (56 cases, 14.2%). For infants and preschool children, the primary disease was predominantly ocular dysplasia at a rate of 81.8% (126 cases) and 55.8% (43 cases), respectively. For school-age children, in addition to ocular dysplasia (58 cases, 35.8%), myopia (49 cases, 30.2%) and ocular trauma (43 cases, 26.5%) also accounted for a large proportion of the primary diseases. The most common type of pediatric retinal detachment was rhegmatogenous retinal detachment (184 cases, 46.8%), and ocular trauma and myopia were the most common primary diseases, accounting for 37.5% (69/184) and 30.4% (56/184), respectively. 170 patients were diagnosed with traction retinal detachment, the second most common type of pediatric retinal detachment, and familial exudative vitreoretinopathy (FEVER) was the main primary disease, accounting for 47.6% (81/170). Exudative retinal detachment (39 cases, 9.9%) was the least common type of pediatric retinal detachment. Coats disease was the main primary disease causing exudative retinal detachment, accounting for 71.8% (28/39). After the first repair surgery, patients who had complete traction retinal detachment generally had poorer anatomical outcomes compared with those with complete rhegmatogenous retinal detachments (|Z|=3.026, P=0.002). The retinal break was most commonly seen on the temporal side in pediatric rhegmatogenous retinal detachments. In the retinal detachments caused by trauma, the most common type of retinal break was retinal tear, followed by ora serrata dialysis. Myopic rhegmatogenous retinal detachments were most commonly found in the round holes in lattice degeneration region.

  Conclusion   In the current study, boys were found to be more susceptible to retinal detachment than girls did. Ocular dysplasia, ocular trauma and myopia were major etiologic factors for pediatric retinal detachment. Appropriate information and education measures should be emphasized for different age groups.