Gonzales Christine R, Singh Surjeet, Yu Fei, Kreiger Allan E, Gupta Anurag, Schwartz Steven D
UCLA Jules Stein Eye Institute, David Geffen School of Medicine, Department of Ophthalmology, Los Angeles, CA, USA.
Retina. 2008 Jun;28(6):847-52. doi: 10.1097/IAE.0b013e3181679f79.
To describe the characteristics of and surgical outcomes for primary pediatric rhegmatogenous retinal detachment (RRD) and to evaluate whether specific characteristics impact anatomical outcomes after surgical intervention.
Data for consecutive patients (18 years of age or younger) with RRD who required surgery over a 5-year period were studied retrospectively. Patients with recurrent retinal detachment or active retinopathy of prematurity were excluded.
Forty-six eyes of 45 patients (median age, 9 years) were included. Ninety-eight percent of the patients had at least 1 predisposing factor, including prior surgery (61%), trauma (43%), developmental abnormality (35%), and myopia (17%). Retinal reattachment was attained in 78% of eyes. Younger age (P = 0.019), worse initial vision (P = 0.008), greater extent of retinal detachment (P = 0.007), and presence of proliferative vitreoretinopathy (grade C or worse) (P = 0.008) were associated with worse anatomical outcomes. Vision improved after surgery in 56% of patients, but overall visual results were modest. Thirty-seven percent of patients had vision-threatening lesions in the other eye, and 18% had a history of retinal detachment in the fellow eye.
Pediatric RRD is often associated with a predisposing factor. Favorable anatomical and visual outcomes are possible, and lesions in the fellow eye are common.
描述原发性儿童孔源性视网膜脱离（RRD）的特征和手术结果，并评估特定特征是否会影响手术干预后的解剖学结果。
回顾性研究连续5年需要手术的RRD患者（18岁及以下）的数据。排除复发性视网膜脱离或活动性早产儿视网膜病变患者。
纳入45例患者的46只眼（中位年龄9岁）。98%的患者至少有1个诱发因素，包括既往手术（61%）、外伤（43%）、发育异常（35%）和近视（17%）。78%的患眼实现视网膜复位。年龄较小（P = 0.019）、初始视力较差（P = 0.008）、视网膜脱离范围较大（P = 0.007）以及存在增殖性玻璃体视网膜病变（C级或更严重）（P = 0.008）与较差的解剖学结果相关。56%的患者术后视力改善，但总体视觉结果一般。37%的患者对侧眼有威胁视力的病变，18%的患者对侧眼有视网膜脱离病史。
儿童RRD常与诱发因素相关。有可能获得良好的解剖学和视觉结果，且对侧眼病变很常见。
