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Pneumatic retinopexy as a treatment for rhegmatogenous retinal detachment in pediatric patients meeting PIVOT criteria

      Abstract

      Objective

      To report the results of pneumatic retinopexy (PnR) as the initial treatment in pediatric patients with rhegmatogenous retinal detachment (RRD) fulfilling The Pneumatic Retinopexy versus Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial (PIVOT) criteria.

      Design

      A retrospective multicentre study.

      Participants

      Pediatric patients who underwent outpatient PnR as the initial treatment for RRD from January 2006 to July 2019 who met PIVOT criteria.

      Methods

      Patients underwent anterior chamber paracentesis followed by intravitreal injection of sulfur hexafluoride (SF6) gas. Either laser retinopexy was performed following retinal reattachment or cryopexy was performed at the time of the initial procedure.

      Results

      A total of 20 eyes of 20 consecutive patients met inclusion criteria and were included in this study. Mean (± standard deviation [SD]) follow-up time was 42.2 ± 38.0 months. Mean patient age was 14.4 years (range, 9–18). There were 17 males and 3 females. The mean (± SD) logMar visual acuity improved from 0.73 ± 0.82 (Snellen equivalent approximately 20/100) to 0.37 ± 0.46 (Snellen equivalent approximately 20/50; p = 0.02) at 3 months and to 0.40 ± 0.54 (Snellen equivalent approximately 20/50; p = 0.05) at last follow-up. Primary reattachment rate was 85% (17/20) at 3 months and 75% (15/20) at last follow-up visit.

      Conclusions

      PnR may be an effective treatment option for RRD in pediatric patients meeting PIVOT criteria.

      Objectif

      Présenter les résultats de la rétinopexie pneumatique (RP) à titre de traitement initial d'un décollement de la rétine rhegmatogène (DRR) qui répondait aux critères de l’étude PIVOT (Pneumatic Retinopexy versus Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial) chez des enfants.

      Nature

      Étude multicentrique rétrospective.

      Participants

      Enfants qui ont subi une RP en ambulatoire à titre de traitement initial d'un DRR qui répondait aux critères de l’étude PIVOT entre janvier 2006 et juillet 2019.

      Méthodes

      Les patients ont subi une paracentèse de la chambre antérieure suivie de l'injection intravitréenne d'un gaz synthétique, l'hexafluorure de soufre (SF6). On a réalisé une rétinopexie au laser après le recollement de la rétine ou une cryopexie au moment de l'intervention initiale.

      Résultats

      Au total, 20 yeux de 20 patients consécutifs répondaient aux critères d'inclusion et ont été admis à cette étude. Le suivi moyen (± écart-type [é.-t.]) était de 42,2 ± 38,0 mois. L’âge moyen des patients (17 garçons et 3 filles) se chiffrait à 14,4 ans (fourchette : 9–18). L'acuité visuelle moyenne (± é.-t.) est passée de 0,73 ± 0,82 logMar (équivalent approximatif de 20/100 sur l’échelle Snellen) à 0,37 ± 0,46 logMar (équivalent approximatif de 20/50 sur l’échelle Snellen; p = 0,02) à 3 mois et à 0,40 ± 0,54 logMar (équivalent approximatif de 20/50 sur l’échelle Snellen; p = 0,05) lors de la dernière visite de suivi. Le taux de recollement primaire était de 85 % (17/20) à 3 mois, puis de 75 % (15/20) lors de la dernière visite de suivi.

      Conclusions

      La RP peut constituer un traitement efficace du DRR qui répond aux critères de l’étude PIVOT chez des enfants.
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