A consecutive series of 59 patients (62 eyes) aged <16 years with MHs (lamellar and full-thickness) treated from 2013 to 2021 in a tertiary center was reviewed. Data collected included demographic and clinical characteristics, management, and outcomes of patients presenting with LMH.
Twelve eyes (19.4%) of 11 children had LMH. Seven patients were male, with an average age of 6.9 years. The primary pathologies included X-linked retinoschisis in six eyes (50%); familial exudative vitreoretinopathy in two (16.7%); and ocular toxocariasis, Coats disease, persistent hyperplastic primary vitreous, and idiopathic LMH with associated lenticonus in one eye (8.3%) each. Four eyes (36.4%) showed tractional appearance and seven (63.6%) degenerative. All degenerative LMH showed ellipsoidal zone defect, significantly higher than that in the tractional group (25%, 1/4) ( P = 0.024). Five eyes achieved closed LMH and limited visual gain, four underwent surgery, and one closed spontaneously.
X-linked retinoschisis was the most frequent primary cause in pediatric LMH. Two types of LMH can be classified: tractional and degenerative. The latter showed a higher rate of ellipsoidal zone defect. Vision improved after LMH closed, regardless of surgery or spontaneous closure.
方法:回顾了2013年至2021年在三级中心接受MHs(层状和全层)治疗的59例患者(62眼),年龄<16岁。收集的数据包括人口统计学和临床特征,管理,以及LMH患者的预后。
结果:11名儿童中有12只眼睛(19.4%)患有LMH。七名患者是男性,平均年龄为6.9岁。主要病理包括6只眼的X连锁视网膜劈裂(50%);2只家族性渗出性玻璃体视网膜病变(16.7%);和眼部弓形虫病,Coats病,持续性增生性原发性玻璃体,和特发性LMH,每只一只眼(8.3%)相关。四眼(36.4%)表现为牵引外观和七眼(63.6%)退行性。所有退行性LMH均显示椭圆形区缺损,显著高于牵引组(25%,1/4)(P=0.024)。五只眼睛实现了闭合的LMH和有限的视觉增益,四个人接受了手术,一个是自发关闭的。
结论:X连锁视网膜裂孔是小儿LMH最常见的主要原因。LMH可以分为两种类型:牵引和退行性。后者显示出更高的椭球区缺陷率。LMH关闭后视力改善,无论手术或自发关闭。