Sin Helena P Y, Yip Wilson W K, Chan Vesta C K, Young Alvin L
Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR.
Int Ophthalmol. 2017 Aug;37(4):875-883. doi: 10.1007/s10792-016-0287-3. Epub 2016 Sep 14.
The purpose of this study was to study the etiologies and operative outcomes of pediatric retinal detachment at a tertiary eye referral center in Hong Kong over a 10-year period. A retrospective study of patients (below 18 years of age) who received primary retinal detachment repair operations at a University Teaching Hospital between 2005 and 2015 was conducted. The study comprised 37 patients with 39 eyes affected who received primary retinal detachment (RD) surgery. Two patients had bilateral RD. 69.2 % were male. The mean follow-up period was 40.6 ± 28.6 months. Their mean age at presentation was 13.4 ± 5.5 years. There were contributing factors for RD identified in 33 eyes (84.6 %), of which congenital/developmental anomalies (23.1 %), high myopia with refractive error greater than -6 diopters (17.9 %), and trauma (15.4 %) ranked the top 3 causes for RD. The retina was reattached after one surgical procedure in 69.2 %. Final anatomical success rate was 82.1 %. Postoperatively, 68.8 % of eyes had improved or stable vision. Functional visual loss with visual acuity less than 5/200 was found to be 30.6 % of eyes which were mostly from younger patients and those with congenital anomalies. Pediatric retinal detachment is often associated with predisposing factors. The presence of congenital/developmental ocular anomalies causing retinal detachment is more frequent in younger children and with worse functional and visual outcomes. Continuing efforts to improve treatment strategies for this group of patients are needed.
本研究的目的是在香港一家三级眼科转诊中心，对10年间小儿视网膜脱离的病因及手术结果进行研究。对2005年至2015年期间在一所大学教学医院接受原发性视网膜脱离修复手术的患者（18岁以下）进行了回顾性研究。该研究包括37例患者的39只患眼，这些患者接受了原发性视网膜脱离（RD）手术。两名患者为双侧RD。男性占69.2%。平均随访期为40.6±28.6个月。他们就诊时的平均年龄为13.4±5.5岁。在33只眼中（84.6%）发现了导致RD的相关因素，其中先天性/发育异常（23.1%）、近视度数大于-6屈光度的高度近视（17.9%）和外伤（15.4%）是RD的前三大病因。69.2%的患者在一次手术后视网膜复位。最终解剖成功率为82.1%。术后，68.8%的患眼视力改善或稳定。视力低于5/200的功能性视力丧失在患眼中占30.6%，主要见于年轻患者和患有先天性异常的患者。小儿视网膜脱离常与易感因素有关。导致视网膜脱离的先天性/发育性眼部异常在年幼儿童中更为常见，其功能和视觉预后更差。需要继续努力改进针对这组患者的治疗策略。
