A comparative analysis of clinical and morphological features of retinal detachment in pediatric and adult practice
https://doi.org/10.21516/2072-0076-2021-14-1-56-60
Abstract
Рurpose. A comparative analysis of clinical and morphological features of retinal detachment (RD) in pediatric and adult practice.
Materials and methods. A retrospective analysis of 100 case histories of patients with a confirmed diagnosis of RD in children aged 7 to 18 (mean age 12.6 ± 1.2 years) and adults aged 19 to 80 (mean age 56.8 ± 2.4 years) was performed prior to standard surgery (subtotal vitrectomy with endolaser coagulation and filling of the vitreous cavity with tamponade substances) and 6 months after it. The main parameters for the comparative analysis were gender, age, RD type, cause (risk factor), stage of development of proliferative vitreoretinopathy (PVR), best corrected distance visual acuity, intraocular pressure, presence of postoperative complications, anatomical adherence of the retina after surgery, the fact of reoperation. Statistical analysis was carried out according to two criteria — chi-square and Fisher's test.
Results. Statistically significant differences in the type and cause (risk factors) of RD, were found. In children, rhegmatogenous RD was less common than in adults (69 % of cases compared with 80 % of cases), while traction RD was more common in children (29 % of cases compared to 19 % of adult cases). The C stage of PVR development in children were found to be almost twice as common as in adults. Postsurgical outcomes were found to be significantly higher in adults compared with children.
Conclusion. RD type, causes and outcomes are statistically different in pediatric and adult practice. Significantly less successful functional and anatomical results of RD surgery in children reflect differences in etiology, pathogenetic features (PVR stage) of the disease, as well as an increased risk of postoperative complications.
About the Authors
A. A. SergienkoRussian Federation
Alexei A. Sergienko — ophthalmologist Scientific Research Institute — S.V. Ochapovsky Regional Clinic Hospital.
Health, 1, pl. Pobedy, Krasnodar, 1350007
A. V. Malyshev
Russian Federation
Alexei V. Malyshev — Dr. of Med. Sci., head of the ophthalmology department, chief ophthalmologist of the Krasnodar Region Ministry of Health.
167, May 1 str., Krasnodar, 350086
A. S. Apostolova
Russian Federation
Anastasia S. Apostolova — Cand. of Med. Sci., ophthalmologist of diagnostic department.
18, Krasnykh Partizan st., Krasnodar, 350047
References
1. Meier P. Pediatric Retinal Detachment. Klin. Monbl. Augenheilkd. 2019; 236 (1): 74–87. doi: 10.1055/s-0043-106301
2. Gurler B., Coskun E., Öner V., et al. Clinical characteristics and surgical outcomes of paediatric rhegmatogenous retinal detachment. Int Ophthalmol. 2016; 36 (4): 521–5. doi:10.1007/s10792-015-0158-3
3. Nuzzi R., Lavia C., Spinetta R. Pediatric retinal detachment: a review. Int. J. Ophthalmol. 2017; Oct 18; 10 (10): 1592–603. doi: 10.18240/ijo.2017.10.18
4. Barth T., Zeman F., Helbig H., et al. Clinical features and outcome of paediatric retinal detachment. Ophthalmologica. 2017; 237 (2): 63–72. doi: 10.1159/000455355
5. Read S., Aziz H., Kuriyan A., et al. Retinal detachment surgery in pediatric population. Visual and anatomic outcomes. Retina. 2018 Jul; 38 (7): 1393–402. doi: 10.1097/IAE.0000000000001725
6. Zafar S.N., Qureshi N., Azad N. Retinal detachment in paediatric patients. J. Coll. Physicians Surg. Pak. 2013 Apr; 23 (4): 261–4. PMID: 23552535
7. Smith J.M., Ward L.T., Townsend J.H., et al. Rhegmatogenous retinal detachment in children: clinical factors predictive of successful surgical repair. Ophthalmology. 2019 Sep; 126 (9): 1263–70. doi: 10.1016/j.ophtha.2018.11.001
8. Soliman M.M., Macky T.A. Pediatric rhegmatogenous retinal detachment. Int. Ophthalmol. Clin. 2011 Winter; 51 (1): 147–71. doi: 10.1097/IIO.0b013e31820099c5
9. Machemer R., Aaberg T.M., Freeman H.M., et al. An updated classification of retinal detachment with proliferative vitreoretinopathy. Am. J. Ophthalmol. 1991; 112 (2): 159–65.
10. Rebrova O.Yu. Application of the STATISTICA package. Statistical analysis of medical data. Moscow: Media Sfera; 2006 (in Russian).
11. Rumelt S., Sarrazin L., Averbukh E., et al. Paediatric vs adult retinal detachment. Eye (Lond). 2007 Dec; 21 (12): 1473–8. doi: 10.1038/sj.eye.6702511
12. Stopa M., Kociecki J., Rakowicz P., et al. Comparison of anatomic and functional results after retinotomy for retinal detachment in pediatric and adult patients. Eur. J. Ophthalmol. May-Jun 2013; 23 (3): 410–6. doi: 10.5301/ejo.5000221
13. Fivgas G.D., Capone A. Pediatric rhegmatogenous retinal detachment. Retina. 2001; 21 (2): 101–6. doi: 10.1097/00006982-200104000-00001.
14. Butler T.K., Kiel A.W., Orr G.M. Anatomical and visual outcome of retinal detachment surgery in children. Br. J. Ophthalmol. 2001 Dec; 85 (12): 1437–9. doi: 10.1136/bjo.85.12.1437
15. Weinberg D.V., Lyon A.T., Greenwald. M.J., et al. Rhegmatogenous retinal detachments in children: risk factors and surgical outcomes. Ophthalmology. 2003 Sep; 110 (9): 1708–13. doi: 10.1016/S0161-6420(03)00569-4
16. Soheilian M., Ramezani A., Malihi M., et al. Clinical features and surgical outcomes of pediatric rhegmatogenous retinal detachment Retina. 2009 Apr; 29 (4): 545–51. doi: 10.1097/IAE.0b013e318194fd1a
17. Wang N.K., Tsai C.H., Chen Y.P., et al. Pediatric rhegmatogenous retinal detachment in East Asians. Ophthalmology. 2005 Nov; 112 (11): 1890–5. doi: 10.1016/j.ophtha.2005.06.019
18. Wadhwa N., Venkatesh P., Sampangi R., et al. Rhegmatogenous retinal detachments in children in India: clinical characteristics, risk factors, and surgical outcomes J. AAPOS. 2008 Dec; 12 (6): 551–4. doi: 10.1016/j.jaapos.2008.05.002
19. Gurler B., Coskun E., Öner V., et al. Clinical characteristics and surgical outcomes of pediatric rhegmatogenous retinal detachment. Int. Ophthalmol. 2016 Aug; 36 (4): 521–5. doi: 10.1007/s10792-015-0158-3
20. Gan N.Y., Lam W.C. Retinal detachments in the pediatric population. Taiwan J. Ophthalmol. 2018 Oct-Dec; 8 (4): 222236. doi: 10.4103/tjo.tjo_104_18
21. Kouassi A.C., Kouassi F.X., Kra A.N.S., et al. Retinal detachment surgery: Evaluation of the anatomical success and functional outcomes in a consecutive series of patients operated between 2011 and 2014 at Nantes University Medical Center. J. Fr. Ophtalmol. 2018 Oct; 41 (8): 744–51. doi: 10.1016/j.jfo.2018.01.022
22. Rejdak R., Nowakowska D., Wrona K., et al. Outcomes of vitrectomy in pediatric retinal detachment with proliferative vitreoretinopathy. J. Ophthalmol. 2017; 2017: 8109390. doi: 10.1155/2017/8109390
23. Malyshev A.V., Deputatova A.N., Balayan A.S. New approaches to the treatment of the epiretinal membrane from the standpoint of antioxidant protection. Kuban Scientific Medical Bulletin. 2015; 3: 84–8 (i n Russian).
24. Shishkin M.M., Yuldasheva N.M., Hajiyeva K.T., et al. Complex antioxidant pharmacotherapy in the rehabilitation of patients with advanced proliferative diabetic retinopathy after vitreoretinal surgery. Russian ophthalmological journal. 2011: 4 (4): 76–82 (in Russian).
25. Maeno A., Suzuki Y., Adachi K., et al. Characterization of the biological antioxidant potential in the vitreous fluid from patients with rhegmatogenous retinal detachment. Acta Ophthalmol. 2016 Sep; 94 (6): e515-516. doi: 10.1111/aos.13002
26. Siegfried C.J., Shui Y. Intraocular oxygen and antioxidant status: new insights on the effect of vitrectomy and glaucoma pathogenesis. Am. J. Ophthalmol. 2019 Jul; 203: 12–25. doi: 10.1016/j.ajo.2019.02.008
Review
For citations:
Sergienko A.A., Malyshev A.V., Apostolova A.S. A comparative analysis of clinical and morphological features of retinal detachment in pediatric and adult practice. Russian Ophthalmological Journal. 2021;14(1):56-60. (In Russ.) https://doi.org/10.21516/2072-0076-2021-14-1-56-60