Distinguishing features of nontraumatic and traumatic retinal dialyses
Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United StatesRetina (Impact Factor: 3.24). 11/2004; 24(5):669-75. DOI: 10.1097/00006982-200410000-00001
Non-traumatic retinal dialysis represents a distinct clinical syndrome which typically occurs in emmentropic young males, affects the inferotemporal quadrant, is often bilateral, and may have ethnic risk factors.
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ABSTRACT: To provide contemporary data on the aetiology of paediatric rhegmatogenous retinal detachment (RRD) in the UK population. Retrospective case series. Eighty-eight eyes in 82 patients (aged 0-16 years) were treated for RRD at Bristol Eye Hospital between 1 January 1990 and 31 December 2004. Seventy-three per cent of patients were male and the main predisposing factors were trauma (53%), associated conditions (27%), and high myopia (17%). Nineteen per cent of RRDs were idiopathic, and the majority of these were due to infero-temporal dialyses. The macula was detached on presentation in 66% of eyes. The principal causes of paediatric RRDs have not changed over the past 40 years. Those due to congenital cataracts, retinopathy of prematurity, uveitis, and glaucoma are now less prevalent, presumably reflecting advances in their management. Differences with other contemporary series may arise from geographical variation in the prevalence of myopia and other associated conditions, as well as institutional referral patterns. Full examination of the retinal periphery is advised for children with eye injuries (to exclude dialyses).
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ABSTRACT: To compare initial findings and final prognosis of retinal detachments (RDs) secondary to open or closed ocular injuries. This prospective study comprised 50 consecutive patients with open (n = 25, with initial successful repair) or closed (n = 25) globe injuries during a 3-year period (2004-2007), with follow-up of at least 6 months (10.1 ± 5.8 months). The most common surgical procedure (76%) was pars plana vitrectomy. Clinical findings were similar in both groups for RD location and extent, frequency of macular involvement, number and nature of tears, and grade of proliferative vitreoretinopathy. Retinal detachment secondary to open/closed globe injury differed significantly, with longer time to onset after trauma, lower frequency in children, and higher rate of aphakia. Final anatomical and functional prognosis and rate of RD recurrence (25%) were similar in both groups. Good final visual prognosis (≥20/40) was significantly associated with initial visual acuity >20/200 and macula-on RD. Definitive redetachments (n = 3) were related to history of posttrauma endophthalmitis, posterior intraocular foreign body, or severe proliferative vitreoretinopathy. Final prognosis was similar in eyes with RD secondary to open and closed globe injuries. The surgical technique depended mainly on lens status, type of retinal tear (dialysis and giant retinal tear), and the presence of preoperative proliferative vitreoretinopathy. Final prognosis (visual acuity ≥20/40) was associated with initial visual acuity >20/200 and macula-on status.
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