Author: Cagri Besirli (United States)
Co-authors: David Portney, Adam Jacobson, Nathan Liles, Brenda Bohnsack
To determine the clinical characteristics and outcomes of retinal detachments associated with pediatric traumatic open-globe injuries.
A total of 23 eyes in 23 pediatric patients diagnosed with retinal detachment following open globe injuries between August 15, 2012 and February 15, 2020 at one academic institution.
Patient demographics, injury characteristics, presenting signs and symptoms, surgical management, and anatomic and functional outcomes were documented. Univariate and multivariate analysis were conducted to identify presenting factors that impacted final visual outcomes.The primary functional outcome was Best Corrected Visual Acuity (BCVA) of the injured eye at last follow up. The anatomic outcomes were single surgery and final anatomic success.
The median time between initial injury and detection of retinal detachment was 18 days. The macula was detached in 15 (68%) patients. Surgical treatment of the retinal detachment was attempted in 14 of the 23 patients (61%). Pars plana vitrectomy (PPV) was the initial treatment in 13 of 14 patients (93%). Silicone oil was used for initial PPV tamponade in ten (77%). Single surgery anatomic success rate and final anatomic success were 50% and 86% in patients for whom treatment was attempted, respectively. Of all 23 patients, six (26%) recovered vision greater than or equal to 20/200 at last follow up, and only one (4%) was greater than 20/40. In univariate analysis, patient age at the time of injury (p = 0.004), macular attachment (p = 0.032), and recurrent retinal detachment (p = 0.006) were found to have a statistically significant relationship with final visual acuity. In a multivariate analysis, only patient age remained a statistically significant predictor of final visual acuity (p = 0.0174).
We characterized the presenting features, treatment, and outcomes for pediatric patients with retinal detachment following open globe injury. Final anatomic success rates after surgical intervention were 86%, though single surgery success rates were lower (50%). Functional outcomes were poor. Patient age was found to be the most important factor in predicting final vision.
ONL Therapeutics: Royalty Irenix Medical: Equity, Consulting, Royalty Janssen: Consulting