Long-term evaluation of pars plana vitrectomy in children with Abusive head trauma
| Autor: | Jana Stepankova, Pavel Kozner, Dagmar Dotrelova |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pars plana
medicine.medical_specialty genetic structures medicine.medical_treatment Visual Acuity Vitrectomy Head trauma 03 medical and health sciences 0302 clinical medicine medicine Retrospective analysis Craniocerebral Trauma Humans Child Retrospective Studies Intraocular hemorrhage business.industry Retinal Detachment General Medicine Shaken baby syndrome medicine.disease Surgery Ophthalmology medicine.anatomical_structure Vitreous hemorrhage 030221 ophthalmology & optometry business 030217 neurology & neurosurgery |
| Zdroj: | European Journal of Ophthalmology. 32:553-558 |
| ISSN: | 1724-6016 1120-6721 |
| Popis: | Purpose: To determine the efficacy of pars plana vitrectomy (PPV) in children with intraocular hemorrhage (IOH) secondary to Abusive head trauma (AHT). Methods: A long-term retrospective analysis evaluating epidemiology, management, safety, anatomical and functional results of PPV for IOH in children with AHT at tertiary referral center for children in the Czech Republic from 2004 to 2017. Results: 18 children were identified with IOH due to AHT during observation period of 14 years. Overall incidence of IOH related to AHT was 29.6/100 000, in children under 1 year 22.2/100 000, in children 1 to 5 years 7.4/100 000. Mean age at the time of diagnosis was 13.7 (SD±20.53) months, median 5 months. IOH resolved in 56% of children, 64% eyes, spontaneously. 44% children, 36% eyes, underwent PPV. PPV was performed 30.5 (SD±16.98) days after established diagnosis on average. Postoperatively, 80% of eyes had anatomical improvement, 20% eyes had preexisting irreversible changes in the posterior pole. Vision of 50% eyes improved after surgery, vision of 20% eyes remained poor, 30% of eyes was not possible to test due to severe neurological impairment. Mean observational period was 33.4 (SD±38.21) months. Mortality rate of AHT in our group was 17%, all victims were younger 4 months. Conclusions: PPV is a safe and effective procedure to clear IOH in children with AHT. Ophthalmology outcomes are strongly associated with degree of neurological impairment. Best outcomes were achieved with PPV performed between 2 and 5 weeks after trauma. Opportunity to plan surgery within this time frame indicates a good neurological prospect and prevents deprivation amblyopia. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|