Characteristics of juvenile retinal detachment

Introduction: Pediatric retinal detachments differ from adult retinal detac hments in their etiologies, prognosis and treatment. The aims of this study were the analysis and long-term follow-up of a group of pediatric retinal detachment patients. Patients and methods: All the cases of juvenile retinal detachments treated in our department between 1987 and 1999 were retrospectively studied. The age at the time of diagnosis, etiology, initial topography of the detachmen t, treatments undertaken, follow-up, and final results were recorded. Results: The study investigated 64 eyes of 53 children. The follow-up was l onger than 6 months for 31 eyes, with a mean follow-up of 39.5 months. The main etiologies were traumatism, high myopia, and affections leading to an exudative retinal detachment such as retinoblastoma and Coats disease. Circ ular scleral buckling was often used because of the vitreous cohesiveness i n children. A vitrectomy was frequently associated to treat severe prolifer ative vitreoretinopathy. The final visual acuity was higher than 0.05 in 32 % of the cases. Discussion: The etiological features, late diagnosis and frequency of proli ferative vitreoretinopathy are responsible for the greater severity of reti nal detachments in children. These factors associated with amblyopia lead t o poor Visual prognosis. Conclusion: Retinal detachment in children remains a severe pathology. Howe ver the prognosis seems to be improving with progress in examination techni ques and surgery methods.