PAAO-YO Research:
Linda A Cernichiaro-Espinosa, MD
22 March 2021
Dr. Linda A Cernichiaro-Espinosa, MD is a Retina and Pediatric Intraocular Tumor Specialist. She is the Founding Director of Oftalmologia Integral & RetinaKids MX. Professor at Asociación para Evitar la Ceguera en México IAP.
She recently published several articles. Below are the salient points of the articles published with links.
- 107 eyes from patients with traumatic rhegmatogenous retinal detachment (RRD) due to self injurious behavior were included from 23 international centers.
- 54% had bilateral RRD or phtisis bulbi in the fellow eye at final follow up.
- The most common systemic diagnoses related to SIB were autism spectrum disorder (35.9%), trisomy 21 (21.8%), cognitive impairment (12.8%) and cerebral palsy (12.8%).
- Primary initial surgeries were vitrectomy alone (33.3%), primary scleral buckle (SB) (25.9%) and vitrectomy with SB (39.7%), and 5 prophylactic SBs were placed. Twenty-three eyes (21.5%) with RRDs were deemed inoperable.
- The single surgery anatomic success rate (SSAS) was 23.1% without tamponade (37.2% if including silicone oil), and final reattachment was attained in 80% (36.3% without silicone oil tamponade)
- Funnel-configured RRD (P=0.006) and the presence of grade C proliferative vitreoretinopathy (P=0.002) predicted RRDs that were more likely to fail reattachment
- The use of a SB predicted final attachment rate during the initial surgery (P=0.005) or at any surgery (p=0.008; P=0.012 and 0.002, respectively, if restricting to patients with ≥12 months followup).
- RRD from SIB poses therapeutic challenges due to limited patient cooperation, bilateral involvement, chronic RRDs, and ongoing trauma in a vulnerable and neglected patient population.
- The surgical success rates in this study were some of the lowest in the modern retinal detachment literature.
- The use of a SB may result in better outcomes, and visual function can be restored in some patients.
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Linda A Cernichiaro-Espinosa, MD
Founding Director of Oftalmología Integral & RetinaKids MX. Professor at Asociación para Evitar la Ceguera en México IAP
