Clinical efficacy of minimally invasive vitreous surgery for special rhegmatogenous retinal detachment in children and adolescents_Chinese Journal of Ocular Fundus Diseases

Authors：

Tian Chaowei , Wu Jing ,  Wang Yusheng , Dou Guorui

Department of Ophthalmology, The First Affiliated Hospital Ophthalmology, Air Force Military Medical University, Eye Institute of Chinese PLA, Xi’an 710032, China;

Corresponding author：

Wang Yusheng, Email: wangys003@126.com

Keywords：

Retinal detachment/surgery; Vitreoretinal surgery; Child; Adolescent

DOI：

10.3760/cma.j.issn.1005-1015.2019.06.008

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Objective To observe the clinical efficacy of minimally invasive vitreous surgery (MIVS) for special rhegmatogenous retinal detachment (RRD) in children and adolescents.Methods A retrospective clinical comparative study. Fourteen eyes with special type of RRD in 14 children and adolescents who received the MIVS treatment from January 2014 to January 2019 in Ophthalmology Department of The First Affiliated Hospital Ophthalmology of Air Force Military Medical University, were included in this study. Among them, 8 eyes from 8 males and 6 eyes from 6 females. The age of them ranged from 5 to 17, with the mean age of 12.64±4.11 years. The course of disease was ranged from 1 d to 1 year, and the average of it was 30 d. All the eyes developed the special type RRD, including pseudophakic and aphakic retinal detachment, giant retinal tear with retinal detachment, choroidal detachment associated with retinal detachment, and RRD with ocular dysplasia. In the 14 eyes, there was 2 eyes with retinal detachment in 1 quadrant, 4 eyes in 2 quadrants, 1 eye in 3 quadrants and 7 eyes in total 4 quadrants. All the eyes were treated with 23G or 25G MIVS and filled with irrigation solution, air and silicone oil. In addition, 10.4 months' follow-up for average after surgery were taken to observe the occurrence of retinal reattachment, BCVA and related complications in the eyes.Results In the 14 eyes, 13 (92.9%) of them attained retinal reattachment and 1 eye (7.1%) got a poor retinal reattachment after one operation. At the last follow-up, all the 14 eyes (100.0%) attained retinal reattachment and 5 of them at the filling state of silicone oil. The vision of 8 eyes (57.1%) were improved, 4 eyes (28.6%) have no notable changes and 2 eyes decreased (14.3%). During the operation, iatrogenic retinal breaks were occurred in 1 eye, and silicone oil entered underneath the retina in 1 eye. After the operation, 1 eye suffered a relapse of retinal detachment after the removal of silicone oil and then were filled with it again.Conclusions MIVS is a safe and effective way to treat the special type RRD among the children and adolescents. The rate of retinal reattachment is 92.9% after one surgery and 100.0% at the last follow-up. Therefore, MIVS can help most of eyes with special type RRD to get a stable and improved vision.

Citation： Tian Chaowei, Wu Jing, Wang Yusheng, Dou Guorui. Clinical efficacy of minimally invasive vitreous surgery for special rhegmatogenous retinal detachment in children and adolescents. Chinese Journal of Ocular Fundus Diseases, 2019, 35(6): 558-563. doi: 10.3760/cma.j.issn.1005-1015.2019.06.008 Copy

1.	张少冲, 佘洁婷, 刘文. 小儿视网膜脱离[M]//刘文.临床眼底病(外科卷). 北京: 人民卫生出版社, 2014: 403-411.Zhang SC, She JT, Liu W. Retinal detachment in children[M]//Liu W. Diseases of clinical ocular fundus(surgical roll). Beijing: People's Medical Publishing House, 2014: 403-411.
2.	Moisseiev J, Vidne O, Treister G. Vitrectomy and silicone oil injection in pediatric patients[J]. Retina, 1998, 18(3): 221-227. DOI: 10.1097/00006982-199803000-00005.
3.	Akabane N, Yamamoto S, Tsukahara I, et al. Sergical outcomes in juvenile retinal detachment[J]. Jpn J Ophthalmol, 2001, 45(4): 409-411. DOI: 10.1016/S0021-5155(01)00361-6.
4.	Ferrone PJ, McCuen BW, de Juan E, et al. The efficacy of silicone oil for complicated retinal detachments in the pediatric population[J]. Arch Ophthalmol, 1994, 112(6): 773-777. DOI: 10.1001/archopht.1994.01090180071037.
5.	张海江, 刘文, 霍鸣. 全玻璃体切除术治疗小儿视网膜脱离[J]. 中国实用眼科杂志, 2012, 30(5): 602-605. DOI: 10.3760/cma.j.issn.1006-4443.2012.05.027.Zhang HJ, Liu W, Huo M. Therapeutic effects of total vitrectomy surgery for pediatric retinal detachment[J]. Chin J Pract Ophthalmol, 2012, 30(5): 602-605. DOI: 10.3760/cma.j.issn.1006-4443.2012.05.027.
6.	Patnaik B, Kalsi R. Retinal detachment with coloboma of the choroid[J]. Indian J Ophthalmol, 1981, 29(4): 345-349. DOI: 10.1136/bmj.1.1054.385-a.
7.	Gopal L, Badrinath SS, Kumar KS, et al. Optic disc in fundus coloboma[J]. Ophthalmology, 1996, 103(12): 2126-2127. DOI: 10.1016/S0161-6420(96)30380-1.
8.	惠延年, 梁雪枝, 刘兵, 等. 玻璃体手术治疗先天性脉络膜缺损合并视网膜脱离[J]. 眼外伤职业眼病杂志, 1999, 21(4): 285-286.Hui YN, Liang XZ, Liu B, et al. Vitreous surgery for retinal detachment with congenital choroidal colobpma[J]. J Ocul Traum Occupat Eye Dis, 1999, 21(4): 285-286.
9.	Hotta K, Hirakata A, Hida T. The management of retinal detachments associated with choroidal colobomas by vitrectomy with cyanoacrylate retinopexy[J]. Jan J Ophthalmolo, 1998, 42(4): 323-326. DOI: 10.1016/S0021-5155(98)00018-5.
10.	Yokoyama T, Kato T, Minamoto A, et al. Characteristics and surgical outcomes of paediatric retinal detachment[J]. Eye(Lond), 2004, 18(9): 889-892. DOI: 10.1038/sj.eye.6701341.
11.	Chen SN, Jiunn-Feng H, Te-Cheng Y. Pediatric rhegmatogenous retinal detachment in Taiwan[J]. Retina, 2006, 26(4): 410-414. DOI: 10.1097/01.iae.0000238546.51756.cd.
12.	邢怡桥, 周晶, 李拓. 家族性渗出性视网膜病变的诊断和治疗[J]. 国际眼科杂志, 2018, 18(11): 1978-1981. DOI: 10.3980/j.issn.1672-5123.2018.11.07.Xing YQ, Zhou J, Li T. Diagnosis and management of familial exudative vitreoretinopathy[J]. Int Eye Sci, 2018, 18(11): 1978-1981. DOI: 10.3980/j.issn.1672-5123.2018.11.07.
13.	何广辉, 陈松, 王健, 等. 巩膜扣带手术和玻璃体切割手术治疗不同分期家族性渗出性玻璃体视网膜病变合并孔源性视网膜脱离的疗效观察[J]. 中华眼底病杂志, 2016, 32(5): 510-513. DOI: 10.3760/cma.j.issn.1005-1015.2016.05.012.He GH, Chen S, Wang J, et al. Clinical observation of sclera buckle and vitrectomy treating different stages of familial exudative vitreoretinopathy associated rhegmatogenous retinal detachment[J]. Chin J Ocul Fundus Dis, 2016, 32(5): 510-513. DOI: 10.3760/cma.j.issn.1005-1015.2016.05.012.
14.	Yamane T, Yokoi T, Nakayama Y, et al. Surgical outcomes of progressive tractional retinal detachment saaociated with familial exudative vitreoretinopathy[J]. Am J Ophthalmol, 2014, 158(5): 1049-1055. DOI: 10.1016/j.ajo.2014.08.009.
15.	王熙娟, 梁建宏, 尹虹, 等. 巩膜扣带手术和玻璃体切割手术治疗家族性渗出性玻璃体视网膜病变疗效观察[J]. 中华眼底病杂志, 2016, 32(1): 36-39. DOI: 10.3760/cma.j.issn.1005-1015.2016.01.009.Wang XJ, Liang JH, Yin H, et al. Effects of scleral buckling and vitrectomy for familial exudative vitreoretinopathy[J]. Chin J Ocul Fundus Dis, 2016, 32(1): 36-39. DOI: 10.3760/cma.j.issn.1005-1015.2016.01.009.
16.	陈奕烨, 赵培泉. 家族性渗出性玻璃体视网膜病变[M]//刘文. 临床眼底病(外科卷). 北京: 人民卫生出版社, 2014: 429-442.Chen YY, Zhao PQ. Familial exudative vitreoretinopathy[M]//Liu W. Clinical fundus diseases (surgical roll). Beijing: People's Medical Publishing House, 2014: 429-442.
17.	刘三梅, 钟捷, 樊映川. 白化病合并孔源性视网膜脱离2例[J]. 国际眼科杂志, 2007, 7(3): 879-880. DOI: 10.3969/j.issn.1672-5123.2007.03.100.Liu SM, Zhong J, Fan YC. Albinism with rhegmatogenous retinal detachment in 2 cases[J]. Int Eye Sci, 2007, 7(3): 879-880. DOI: 10.3969/j.issn.1672-5123.2007.03.100.
18.	王光璐. 光相干断层成像的特色和不足[J]. 眼科研究, 2005, 23(6): 561-563. DOI: 10.3760/cma.j.issn.2095-0160.2005.06.001.Wang GL. Characteristics of OCT examination[J]. Chin Ophthal Res, 2005, 23(6): 561-563. DOI: 10.3760/cma.j.issn.2095-0160.2005.06.001.
19.	Theodossiadis PG, Grigoropoulos VG, Emfietzoglou J, et al. Vitreous findings in optic disc pit maculopathy based on optical coherence tomography[J]. Graefe’s Arch Clin Exp Ophthalmol, 2007, 245(9): 1311-1318. DOI: 10.1007/s00417-007-0534-4.
20.	Qayun S, Sullivan T, Park SC, et al. Structure and clinical significance of central optic disc pits[J]. Ophthalmology, 2013, 120(7): 1415-1422. DOI: 10.1016/j.ophtha.2012.12.034.
21.	姚进, 蒋沁. 自体内界膜填塞治疗先天性视盘小凹伴浆液性视网膜脱离[J]. 南京医科大学学报, 2015, 35(2): 292-294. DOI: 10.7655/NYDXBNS20150237.Yao J, Jiang Q. Treatment of congenital fovea of optic disc with serous retinal detachment with autogenous internal limiting membrane[J]. Acta Universitatis Medicinalis Nanjing, 2015, 35(2): 292-294. DOI: 10.7655/NYDXBNS20150237.
22.	Von Fricken MA, Dhungel R. Retinal detachment in the morning glory syndrome, pathogenesis and management[J]. Retina, 1984, 4(2): 97-99. DOI: 10.1097/00006982-198400420-00004.
23.	Manschot WA. Morning glory syndrome:a histopathological study[J]. Br J Ophthalmol, 1990, 74(1): 56-58. DOI: 10.1136/bjo.74.1.56.
24.	Ho CL, Wei LC. Rhegmatogenous retinal detachment in morning glory syndrome--pathogenesis and treatment[J]. Int Ophthalmol, 2001, 24(1): 21-24. DOI: 10.1023/a:1014498717741.

1. 张少冲, 佘洁婷, 刘文. 小儿视网膜脱离[M]//刘文.临床眼底病(外科卷). 北京: 人民卫生出版社, 2014: 403-411.Zhang SC, She JT, Liu W. Retinal detachment in children[M]//Liu W. Diseases of clinical ocular fundus(surgical roll). Beijing: People's Medical Publishing House, 2014: 403-411.
2. Moisseiev J, Vidne O, Treister G. Vitrectomy and silicone oil injection in pediatric patients[J]. Retina, 1998, 18(3): 221-227. DOI: 10.1097/00006982-199803000-00005.
3. Akabane N, Yamamoto S, Tsukahara I, et al. Sergical outcomes in juvenile retinal detachment[J]. Jpn J Ophthalmol, 2001, 45(4): 409-411. DOI: 10.1016/S0021-5155(01)00361-6.
4. Ferrone PJ, McCuen BW, de Juan E, et al. The efficacy of silicone oil for complicated retinal detachments in the pediatric population[J]. Arch Ophthalmol, 1994, 112(6): 773-777. DOI: 10.1001/archopht.1994.01090180071037.
5. 张海江, 刘文, 霍鸣. 全玻璃体切除术治疗小儿视网膜脱离[J]. 中国实用眼科杂志, 2012, 30(5): 602-605. DOI: 10.3760/cma.j.issn.1006-4443.2012.05.027.Zhang HJ, Liu W, Huo M. Therapeutic effects of total vitrectomy surgery for pediatric retinal detachment[J]. Chin J Pract Ophthalmol, 2012, 30(5): 602-605. DOI: 10.3760/cma.j.issn.1006-4443.2012.05.027.
6. Patnaik B, Kalsi R. Retinal detachment with coloboma of the choroid[J]. Indian J Ophthalmol, 1981, 29(4): 345-349. DOI: 10.1136/bmj.1.1054.385-a.
7. Gopal L, Badrinath SS, Kumar KS, et al. Optic disc in fundus coloboma[J]. Ophthalmology, 1996, 103(12): 2126-2127. DOI: 10.1016/S0161-6420(96)30380-1.
8. 惠延年, 梁雪枝, 刘兵, 等. 玻璃体手术治疗先天性脉络膜缺损合并视网膜脱离[J]. 眼外伤职业眼病杂志, 1999, 21(4): 285-286.Hui YN, Liang XZ, Liu B, et al. Vitreous surgery for retinal detachment with congenital choroidal colobpma[J]. J Ocul Traum Occupat Eye Dis, 1999, 21(4): 285-286.
9. Hotta K, Hirakata A, Hida T. The management of retinal detachments associated with choroidal colobomas by vitrectomy with cyanoacrylate retinopexy[J]. Jan J Ophthalmolo, 1998, 42(4): 323-326. DOI: 10.1016/S0021-5155(98)00018-5.
10. Yokoyama T, Kato T, Minamoto A, et al. Characteristics and surgical outcomes of paediatric retinal detachment[J]. Eye(Lond), 2004, 18(9): 889-892. DOI: 10.1038/sj.eye.6701341.
11. Chen SN, Jiunn-Feng H, Te-Cheng Y. Pediatric rhegmatogenous retinal detachment in Taiwan[J]. Retina, 2006, 26(4): 410-414. DOI: 10.1097/01.iae.0000238546.51756.cd.
12. 邢怡桥, 周晶, 李拓. 家族性渗出性视网膜病变的诊断和治疗[J]. 国际眼科杂志, 2018, 18(11): 1978-1981. DOI: 10.3980/j.issn.1672-5123.2018.11.07.Xing YQ, Zhou J, Li T. Diagnosis and management of familial exudative vitreoretinopathy[J]. Int Eye Sci, 2018, 18(11): 1978-1981. DOI: 10.3980/j.issn.1672-5123.2018.11.07.
13. 何广辉, 陈松, 王健, 等. 巩膜扣带手术和玻璃体切割手术治疗不同分期家族性渗出性玻璃体视网膜病变合并孔源性视网膜脱离的疗效观察[J]. 中华眼底病杂志, 2016, 32(5): 510-513. DOI: 10.3760/cma.j.issn.1005-1015.2016.05.012.He GH, Chen S, Wang J, et al. Clinical observation of sclera buckle and vitrectomy treating different stages of familial exudative vitreoretinopathy associated rhegmatogenous retinal detachment[J]. Chin J Ocul Fundus Dis, 2016, 32(5): 510-513. DOI: 10.3760/cma.j.issn.1005-1015.2016.05.012.
14. Yamane T, Yokoi T, Nakayama Y, et al. Surgical outcomes of progressive tractional retinal detachment saaociated with familial exudative vitreoretinopathy[J]. Am J Ophthalmol, 2014, 158(5): 1049-1055. DOI: 10.1016/j.ajo.2014.08.009.
15. 王熙娟, 梁建宏, 尹虹, 等. 巩膜扣带手术和玻璃体切割手术治疗家族性渗出性玻璃体视网膜病变疗效观察[J]. 中华眼底病杂志, 2016, 32(1): 36-39. DOI: 10.3760/cma.j.issn.1005-1015.2016.01.009.Wang XJ, Liang JH, Yin H, et al. Effects of scleral buckling and vitrectomy for familial exudative vitreoretinopathy[J]. Chin J Ocul Fundus Dis, 2016, 32(1): 36-39. DOI: 10.3760/cma.j.issn.1005-1015.2016.01.009.
16. 陈奕烨, 赵培泉. 家族性渗出性玻璃体视网膜病变[M]//刘文. 临床眼底病(外科卷). 北京: 人民卫生出版社, 2014: 429-442.Chen YY, Zhao PQ. Familial exudative vitreoretinopathy[M]//Liu W. Clinical fundus diseases (surgical roll). Beijing: People's Medical Publishing House, 2014: 429-442.
17. 刘三梅, 钟捷, 樊映川. 白化病合并孔源性视网膜脱离2例[J]. 国际眼科杂志, 2007, 7(3): 879-880. DOI: 10.3969/j.issn.1672-5123.2007.03.100.Liu SM, Zhong J, Fan YC. Albinism with rhegmatogenous retinal detachment in 2 cases[J]. Int Eye Sci, 2007, 7(3): 879-880. DOI: 10.3969/j.issn.1672-5123.2007.03.100.
18. 王光璐. 光相干断层成像的特色和不足[J]. 眼科研究, 2005, 23(6): 561-563. DOI: 10.3760/cma.j.issn.2095-0160.2005.06.001.Wang GL. Characteristics of OCT examination[J]. Chin Ophthal Res, 2005, 23(6): 561-563. DOI: 10.3760/cma.j.issn.2095-0160.2005.06.001.
19. Theodossiadis PG, Grigoropoulos VG, Emfietzoglou J, et al. Vitreous findings in optic disc pit maculopathy based on optical coherence tomography[J]. Graefe’s Arch Clin Exp Ophthalmol, 2007, 245(9): 1311-1318. DOI: 10.1007/s00417-007-0534-4.
20. Qayun S, Sullivan T, Park SC, et al. Structure and clinical significance of central optic disc pits[J]. Ophthalmology, 2013, 120(7): 1415-1422. DOI: 10.1016/j.ophtha.2012.12.034.
21. 姚进, 蒋沁. 自体内界膜填塞治疗先天性视盘小凹伴浆液性视网膜脱离[J]. 南京医科大学学报, 2015, 35(2): 292-294. DOI: 10.7655/NYDXBNS20150237.Yao J, Jiang Q. Treatment of congenital fovea of optic disc with serous retinal detachment with autogenous internal limiting membrane[J]. Acta Universitatis Medicinalis Nanjing, 2015, 35(2): 292-294. DOI: 10.7655/NYDXBNS20150237.
22. Von Fricken MA, Dhungel R. Retinal detachment in the morning glory syndrome, pathogenesis and management[J]. Retina, 1984, 4(2): 97-99. DOI: 10.1097/00006982-198400420-00004.
23. Manschot WA. Morning glory syndrome:a histopathological study[J]. Br J Ophthalmol, 1990, 74(1): 56-58. DOI: 10.1136/bjo.74.1.56.
24. Ho CL, Wei LC. Rhegmatogenous retinal detachment in morning glory syndrome--pathogenesis and treatment[J]. Int Ophthalmol, 2001, 24(1): 21-24. DOI: 10.1023/a:1014498717741.

Chinese Journal of Ocular Fundus Diseases

Clinical efficacy of minimally invasive vitreous surgery for special rhegmatogenous retinal detachment in children and adolescents

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