Risk factors for recurrent retinal detachment in children-An observational cohort study

Abstract

Purpose: To describe the epidemiology and determine the risk factors for recurrent paediatric retinal detachments (RD) from a tertiary paediatric ophthalmology referral centre. Methods: Retrospective, observational study of all children ≤18 years old who underwent RD repair at the Queensland Children's Hospital, Brisbane, from November 2014 to December 2022. Data collected included patient demographics, ocular history, detachment characteristics, surgical details and outcome data. The primary outcome measure was anatomic reattachment. Results: Sixty-eight patients, for a total of 75 eyes (75% male) were included. Median age was 11 (interquartile range 8.5-13). Thirty-nine eyes (52%) had anatomic reattachment after initial surgery, improving to 50 eyes (66.7 %) at final follow-up. Univariable analysis identified age, presence of congenital cataracts, total RD and proliferative vitreoretinopathy (PVR) as predictive factors of recurrent detachment. Multivariable analysis found increased age to be predictive of successful reattachment (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.01- 1.31, p-value 0.045), while presence of PVR was a risk factor for recurrent retinal detachment (OR 0.35 95% CI 0.13-0.92, p-value 0.037), after the initial surgery. Factors predictive of successful final reattachment were myopia (OR 5.12, 95% CI 1.23-28.2, p-value 0.036) and presence of only one retinal tear (OR 21.1, 95% CI 3.07, 447, pvalue 0.009), while presence of PVR was again a risk factor for redetachment (OR 0.26, 95% CI 0.07-0.89, p-value 0.038). Conclusion: We identified several factors that significantly influence anatomical success after paediatric RD. Consideration of these characteristics would be important in preoperative counselling as well as in perioperative and post-operative surgical management.