The aim of our work is to evaluate stereoscopic photographic changes in the optic nerve head among patients with glaucoma-compatible optic neuropathy in myopia (GCON-M) after intraocular pressure (IOP) reduction and to determine whether these changes represent true progressive glaucomatous damage. This self-controlled, observational cohort study included 41 patients with bilateral normal-tension GCON-M. The eye with the worse baseline visual field (VF) mean deviation received intraocular pressure (IOP)-lowering treatment targeting a 30

The efficacy of flipped classroom in ophthalmology education has not been well proved. This study aimed to investigate the efficacy of flipped classroom on diabetic retinopathy (DR) and glaucoma in ophthalmology education. Ninety-three medical students in Peking Union Medical College participated and were randomly assigned into two groups. Students in “Group A” participated in a flipped classroom on diabetic retinopathy (DR) and a regular course on glaucoma, while students in “Group B” had a flipped classroom on glaucoma and a regular one on DR. The primary outcome measure of this study was the exam score after class. The secondary outcome measure was the result of a post-classroom questionnaire. The final exam revealed numerically better scores for questions in the same section as flipped classroom that students joined with no statistical significance. The post-class questionnaire revealed an overall satisfaction rate of 93.48%. Most students thought the flipped classroom enhance personal abilities compared with the traditional lecture-based class. However, further amendments should also be made to improve defects such as students’ comprehension of basic knowledge and the overall degree of involvement of students. The concept of the flipped classroom could be applied to diabetic retinopathy and glaucoma with satisfactory results.

Goniosynechialysis (Phaco-GSL) is a logical therapeutic approach for patients with primary angle-closure glaucoma (PACG) and cataract. The aim of this study was to compare the long-term effectiveness and safety of Phaco-GSL and trabeculectomy (TRB) in the management of PACG with coexisting cataract. A review was conducted on 96 Chinese patients (96 eyes) with PACG and cataract from Peking Union Medical College Hospital (PUMCH). Among them, 56 patients underwent Phaco-GSL, while 40 underwent TRB. Intraocular pressure (IOP), best corrected visual acuity (BCVA), use of supplemental antiglaucoma medical therapy, surgery success rates, and complications for both procedures were assessed. The average follow-up period was 50.3 ± 18.7 months in the Phaco-GSL group and 61.2 ± 15.1 months in the TRB group. At the final follow-up, IOP decreased from 27.0 ± 11.1 mmHg to 13.5 ± 2.1 mmHg in the Phaco-GSL group and in the TRB group IOP decreased from 27.1 ± 7.7 mmHg to 16.5 ± 5.5 mmHg. The long-term postoperative IOP in the Phaco-GSL group was significantly lower than that in the TRB group. There was a statistically significant reduction in medication usage in both groups, with the TRB group having a higher number of postoperative medications at the final follow-up. The incidence of postoperative complications was significantly higher in the TRB group compared to the Phaco-GSL group. Phaco-GSL is the recommended surgical approach for Chinese patients with primary angle-closure glaucoma (PACG) and cataract. Compared to traditional TRB, eyes undergoing Phaco-GSL show a reduced requirement for antiglaucomatous medications, improved management of IOP, decreased risk of complications, and higher long-term cumulative probability of treatment success for patients with PACG.

Purpose To compare the difference in anterior segment biometrics derived from anterior segment optical coherence tomography (AS-OCT) between treatment-naïve acromegaly patients and normal controls and evaluate the correlations between above biometrics and insulin-like growth factor 1 (IGF-1) and growth hormone (GH) levels. Methods Sixty eyes of 30 acromegaly patients and 60 eyes of 30 normal controls were included in this case-control study. Central corneal thickness, pupil diameter, iris thickness (IT), iris curvature (IC), anterior chamber depth (ACD), anterior chamber width, lens vault (LV), angle open distance (AOD) 500, AOD750, and trabecular iris space area (TISA) 500 and TISA750 were measured by AS-OCT. General linear regression models were constructed to evaluate the independent endocrine factors affecting iris morphology and anterior chamber angle (ACA) width. Results The acromegaly patients had an evenly thicker iris (P < 0.001), a smaller IC (P < 0.05), a smaller LV (P = 0.040) and significantly larger AOD500, AOD750, TISA500 and TISA750 (P < 0.001). There was a positive correlation between the serum GH level and ACD in the acromegaly patients (P = 0.031). Linear regression models showed the lower LV and smaller IC were independent influencing factors of the increase in the AOD500, AOD750, and TISA750 and nasal TISA500. Serum IGF-1 was an independent factor for the increase in pupil diameter (β = 0.002, P = 0.031) and both the average nasal (β = 6.781*10−5, P = 0.049) and temporal (β = 7.736*10−5, P = 0.045) IT values and for the decrease in temporal IC (β < 0.001, P = 0.037). GH was an independent factor for the increase in temporal AOD750 (β = 0.001, P = 0.030) and temporal TISA750 (β = 0.002, P = 0.016). Conclusions Patients with acromegaly have a thicker IT, smaller IC, and lower LV with a wider ACA than normal controls. Serum GH is independently correlated with the temporal ACA width, whereas serum IGF-1 is independently correlated with IT, pupil diameter, and IC.

Introduction To compare the long-term effect after modified CO2 laser-assisted sclerectomy surgery (MCLASS) and conventional trabeculectomy (TRAB) in medically uncontrolled Chinese primary open-angle glaucoma (POAG) patients. This was a retrospective comparative study. Methods A total of 87 patients were reviewed, including 45 in the MCLASS group and 42 in the TRAB group. Intraocular pressure (IOP), best-corrected visual acuity (BCVA), and use of supplemental medical therapy were retrospectively compared at baseline, and until 36 months postoperatively. Results Patients in both groups achieved a significant IOP decrease from baseline (P < 0.001); postoperative IOP in the MCLASS group was significantly lower than that in the TRAB group at 24 and 36 months. The reduced use of medication was statistically significant in both groups, and the number of postoperative medications was significantly more in TRAB group at 24 and 36 months. At 24 and 36 months, the complete success rate was 60% and 53.3% for MCLASS versus 66.7% and 59.5% for TRAB, and the qualified success rate was 91.1% and 88.9% for MCLASS versus 83.3% and 80.9% for TRAB, respectively. BCVA deterioration post TRAB was clinically more serious than that post MCLASS at 24 and 36 months, although the difference was not statically significant at any time point postoperatively. Compared with MCLASS, more complications occurred postoperatively in the TRAB group. Conclusions MCLASS is an effective surgical option for Chinese POAG patients. Compared to TRAB, eyes undergoing MCLASS experience a comparable success rate, a greater IOP reduction, fewer medications, and a lower risk of complications up to 36 months.

Objective To observe the role of ultrasound biomicroscopy(UBM)in two-year post-operative follow-up for primary open-angle glaucoma patients with modified CO2 laser-assisted sclerectomy surgery(CLASS).Methods This was a case series study.A combination of modified CLASS and preoperative laser iris management was administered to 28 eyes.Visual acuity,intraocular pressure(IOP),and slit-lamp examinations,visual field testing,and gonioscopy were carried out at baseline and until 24 months postoperatively.UBM examination was performed at 1,3,12 and 24 months postoperatively.Results Compared with the mean preoperative IOP [(30.61±10.59)mmHg],the IOP at each time point after operation was significantly lowered [(15.15±5.87),(12.56±3.24),(13.15±2.73),(13.75±2.55)and(13.75±2.46)mmHg at 1,3,6,12 and 24 months,respectively;all P<0.001].Complete success rates and qualified success rates at 12 months and 24 months were 60.71%,89.29% and 53.57%,85.71%,respectively.UBM images can present "dolphin head sign" after successful CLASS.The thickness of trabeculo-Descemet's window was(0.13±0.03)mm,which had no significant correlation with postoperative IOP at 12(r=-0.278,P=0.144)and 24 months(r=0.026,P=0.895).UBM examination revealed a severe scleral lake diminution(a change > 50%)in 1 eye(3.57%)at 12 months and 3 eyes(10.71%)at 24 months.There was no statistical significance detected between the size of the scleral lake and IOP after CLASS.Non-founctional blebs were found in 16 eyes(57.14%)at 12 months and 25 eyes(89.28%)at 24 months.Two eyes(7.14%)demonstrated severe peripheral anterior synechiae at 24 months,requiring surgical intervention.Conclusions UBM can effectively observe the morphology of the scleral lake,anterior chamber angle and filtering blebs in post-operative follow-up after modified CLASS,and give early warning of complications.It plays an important role in ensuring the success of CLASS.

To investigate whether intravitreal conbercept injection affects contralateral untreated eyes in bilateral diabetic macular edema (DME) patients. In this retrospective study, 15 patients (30 eyes) with type 2 diabetes were followed after bilateral DME diagnosis in the Department of Ophthalmology, Peking Union Medical College Hospital from 2015 to 2018. Patients underwent examinations including best corrected visual acuity (BCVA), slit-lamp microscopy, indirect ophthalmoscope, color fundus photography, fundus fluorescein angiography, optical coherence tomography, and glycated hemoglobin (HbA1c). Each patient received conbercept (0.5 mg) intravitreally in the severe eye. Nonparametric Wilcoxon signed-rank tests and Pearson’s correlation coefficient were used to assess changes in BCVA and central retinal thickness (CRT) and relations between BCVA changes in treated and untreated eyes, respectively. The mean follow-up time was 10.60 ± 2.29 months, and the mean injection number of 15 treated eyes was 9.13 ± 0.68. HbA1c remained below 10% during treatment with no significant changes between the initial and final visits (7.81 ± 1.17 vs 7.62 ± 1.19%) (P = 0.576). In untreated eyes, CRT significantly decreased from the initial to final visits (368.93 ± 125.45 vs 306.27 ± 89.70 μm) (P = 0.028). In untreated eyes, BCVA showed no significant difference between the initial and final visits (0.38 ± 0.30 vs 0.40 ± 0.30 logMAR) (P = 0.937), but BCVA changes in treated and untreated eyes were positively correlated (r = 0.527, P = 0.044). Intravitreal conbercept injection results in decreased CRT and increased BCVA in untreated eyes, which is consistent with the changes in treated eyes for patients with bilateral DME.

Background: The retinal microvasculature within the macula in glaucomatous eyes is not clear. Objectives: To detect macular vessel density (MVD) changes in primary angle-closure glaucoma (PACG). Methods: Twenty-two PACG patients who had an episode of acute primary angle closure were included. Structural optical coherence tomography (OCT) scans were conducted to measure the thickness of the peripapillary retinal nerve fiber layer and macular ganglion cell complex (GCC). The MVD was measured with OCT angiography. Results: A weakened macular microvascular network that had an expanded fovea avascular zone was observed in the case group. Compared with the control group, the case group had a lower MVD (p < 0.001). Single correlation analysis revealed a significant correlation of the MVD with best-corrected visual acuity (BCVA) (r = -0.65, p = 0.001), GCC (r = 0.50, p = 0.018), and the visual field mean deviation (r = -0.54, p = 0.009) in the case group. Moreover, in the mixed-effect models, the MVD was found to be positively correlated with GCC (p = 0.017) and negatively correlated with LogMar BCVA (p < 0.001). Conclusions: After an acute angle-closure attack, the macular microvascular network is attenuated, and the MVD decreases significantly.

To investigate if a new ultrasound biomicroscopy (UBM) parameter, iris lens distance (ILD), and its model could predict clinically significant intraocular pressure (IOP) elevation after darkroom provocative test (DRPT). Cases with a peripheral anterior chamber depth less than one-fourth corneal thickness were enrolled. All subjects underwent UBM examination and DRPT if possible. Anterior chamber depth (ACD) and ILD were measured in the central axis at different positions in dark (ACDD, ILDD) and bright (ACDB, ILDB). An IOP elevation over 5 mmHg and 8 mmHg was set as cutoffs for a positive DRPT result (positive-5 and positive-8). SAS 9.3 statistical software was used to manage and analyze data and calculate the linear probability model (LPM). Another 17 patients (34 eyes) were included to validate the model. Two hundred and ten (210) UBM images qualified for analysis. ILD was significantly less in the dark than in the bright and in patients with a positive DRPT result (p < 0.001). The LPM for positive-5 and positive-8 were P = 1.14 + (− 0.49*ILDD) + (− 0.41*ACDD) (n = 210, R2 = 0.1079, AUC = 0.715), and P = 0.87 + (− 0.44*ILDD) + (− 0.35*ACDD) (n = 210, R2 = 0.1358, AUC = 0.807), respectively. LPMs based on ILD could predict the risk of an IOP elevation over 5 mmHg or 8 mmHg. The LPM for positive-8 reached a good level of diagnostic accuracy.

Background: To detect the macular vessel density (MVD) changes in primary angle closure glaucoma (PACG) and to investigate the correlation between MVD and other glaucomatous changes. Methods: A case-control study. Eyes of 22 PACG patients with an episode of acute primary angle closure (APAC) in one of the two eyes. Structural OCT scans were used to obtain peripapillary retinal nerve fiber layer (RNFL), macular ganglion cell complex (GCC) thickness and C/D area ration. OCT angiography (OCTA) was used to measure MVD. Results: In the control group, the dense macular blood vessels were visible on OCTA， the macular vessels were sparse in the case group, and with an enlarged fovea avascular zone. There was a reduction in MVD in the case group compared with the controls (P<0.01). No correlations between MVD, VF mean deviation (MD), C/D area ratio, GCC thickness or RNFL thickness were found in the control group. In the case group, the Pearson correlation analysis showed that MVD was significantly correlated with BCVA (r=0,65, P=0.001), GCC (r=0.50, P=0.018) and VF MD (r=-0.54, P=0.009). In the case group, the multiple stepwise regression analysis, in which MVD were considered the dependent variables, showed that BCVA and GCC were significant predictors. Conclusions: Macular microvascular network attenuated and MVD reduced significantly caused by APAC. MVD was strongly linked to BCVA and GCC.

1) To compare the retinal, choroidal, Haller’s layer, and Sattler’s/choriocapillaris thicknesses of untreated acromegaly patients without chiasm compression or diabetes mellitus and healthy controls. 2) To evaluate the correlations of retinal and choroidal thicknesses with serum growth hormone (GH) and insulin-like growth factor 1 (IGF) burden.

To compare the in vivo lamina cribrosa position in patients with normal‐tension glaucoma (NTG) and high‐tension glaucoma (HTG).

PURPOSE:To investigate whether peripapillary choroidal thickness in perimetrically affected eyes of primary open-angle glaucoma (POAG) patients differs from that in perimetrically unaffected fellow eyes and eyes of healthy controls. DESIGN:Retrospective, comparative, cross-sectional study. METHODS:Thirty-one POAG patients with unilateral visual field loss and 31 healthy controls were included. Eyes were divided into 3 groups: 31 eyes in group A (eyes with visual field loss), 31 eyes in group B (perimetrically unaffected fellow eyes), and 31 eyes in group C (age- and sex-matched controls). A 360-degree 3.4-mm diameter peripapillary circle scan was performed for retinal nerve fiber layer (RNFL) assessment using enhanced depth imaging optical coherence tomography. The observer used the manual segmentation function to delineate the posterior edge of the retinal pigment epithelium and the sclerochoroidal interface. The RNFL thickness algorithm function was used to generate the choroidal thickness automatically in corresponding sectors. Statistical analysis was conducted to compare mean choroidal thickness and RNFL thickness among 3 groups and to correlate choroidal thickness with age, RNFL thickness, and visual field mean deviation. RESULTS:The global mean RNFL and choroidal thickness measurements were 62.3 ± 16.7 μm and 154.3 ± 69.7 μm in group A, 90.4 ± 12.2 μm and 154.7 ± 68.9 μm in group B, and 106.6 ± 9.2 μm and 154.2 ± 60.9 μm in group C. The RNFL thickness was significantly thinner in group A than in groups B and C globally and at all peripapillary locations (all P = .000). The RNFL thickness also was significantly thinner in group B than in group C (P = .000 to .021). However, choroidal thickness measurements did not differ among 3 groups globally or at any peripapillary location (P = .273 to .934, P = .757 to .994, and P = .808 to .975, respectively). Age was the only significant factor associated with peripapillary choroidal thickness in each group (r = -0.418 to -0.641, r = -0.569 to -0.690, and r = -0.689 to -0.827, respectively; all P < .05). CONCLUSIONS:There was no significant difference in peripapillary choroidal thickness of POAG eyes with visual field loss compared with that of perimetrically unaffected fellow eyes and eyes of healthy controls, which does not support using peripapillary choroidal thickness as a clinical parameter in POAG diagnosis or management.

OBJECTIVE:To compare peripapillary choroidal thickness (CT) between primary open angle glaucoma (POAG) and normal subjects using enhanced depth imaging optical coherence tomography (EDI-OCT).METHODS:This research was a cross-sectional study. A 360-degree 3.4 mm diameter peripapillary circle scan was performed for retinal nerve fiber layer (RNFL) assessment by EDI-OCT in one eye of 40 POAG patients and 41 age- and sex-matched normal subjects. The observer used the manual segmentation function to delineate the posterior edge of the retinal pigment epithelium and the sclerochoroidal interface. The RNFL thickness algorithm function was used to automatically generate the CT in corresponding sectors. The intra- and inter-observer reproducibility was evaluated by intraclass correlation coefficient (ICC). Repeated measures ANOVA and LSD-t test were used to analyze differences in CT by peripapillary location. A Pearson correlation was calculated for variation in CT relative to age and RNFL. Spearman rank correlation was calculated to test the strength of the relationship between global mean RNFL and visual field mean deviation (MD) and between CT and MD. Independent-samples t-test was conducted to compare mean RNFL and CT between POAG and normal subjects.RESULTS:The intra- and interobserver ICC values ranged from 0.993 to 0.999 and 0.993 to 0.998 respectively. In both groups, the CT showed a negative correlation with age at each peripapillary location (r = -0.509 to -0.608, -0.549 to -0.668; P = 0.000 to 0.001) but no significant correlation with RNFL for any location (r = -0.186 to 0.273, -0.090 to 0.132; P = 0.092 to 0.869). The peripapillary CT was thickest superotemporally and superonasal, then nasally and temporally, and was thinnest inferotemporally and inferonasal (P = 0.000 to 0.036). Compared to normal subjects, eyes with POAG had significantly thinner RNFL at all locations (t = 6.975 to 16.087, P = 0.000), but CT measurements did not differ between groups for any location (t = -0.474 to 0.367, P = 0.637 to 0.978). In POAG patients, the global mean RNFL (rs = -0.511, P = 0.001) but not CT (rs = -0.285, P = 0.079) was found to significantly correlate with visual field MD.CONCLUSIONS:The peripapillary CT in POAG neither differ from that in normal subjects nor correlate with RNFL and visual field index, which does not support using it as a clinical parameter in glaucoma diagnosis or management.

OBJECTIVE:To evaluate the efficiency of enhanced depth imaging optical coherence tomography (EDI-OCT) on quantifying choroidal thickness (CT) in normal subjects.METHODS:This was a cross-sectional study. From June to November 2011, 129 eyes of 129 normal subjects were enrolled in this study and divided into three groups by age distribution. Group A, 43 eyes, 22 to 40 years old; group B, 42 eyes, 41 to 60 years old and group C, 44 eyes, 61 to 79 years old. They were examined with EDI-OCT for CT. The choroid was measured from the posterior edge of the retinal pigment epithelium to the choroid-scleral junction at 500 µm intervals of a horizontal section from 3 mm temporal to the fovea to 3 mm nasal to the fovea. The paired t test was used to analyze differences in CT by location in the macula. One-way analysis of variance (ANOVA) was conducted to compare mean CT in different groups. Subsequently the data between two groups were analyzed by least significant difference (LSD-t). The reliability was evaluated by intraclass correlation coefficient (ICC).RESULTS:The choroid was thickest beneath the fovea (305.9 ± 78.2) µm. The mean CT decreased rapidly in the nasal direction and gradually in the temporal direction, reaching (159.0 ± 67.3) µm at 3 mm nasal to the fovea and (256.8 ± 73.6) µm at 3 mm temporal to the fovea. There was a significant difference between subfoveal CT and CT at all extrafoveal locations (t = 4.021 to 34.544, P < 0.05). There was also a significant difference of CT at all locations among three age groups (F = 34.122 to 72.239, P < 0.05). CT was significantly greater in group A than group B and C at all locations (P = 0.000, 0.000). It was also significantly greater in group B than group C (P = 0.000). The inter-examination ICC values ranged from 0.979 to 0.996. The intraobserver ICC values ranged from 0.981 to 0.997. The interobserver ICC values ranged from 0.971 to 0.995.CONCLUSIONS:Normal CT can be measured accurately by EDI-OCT. There are significant differences of CT between different age groups in normal subjects.

OBJECTIVE:To evaluate the characteristics of choroidal thickness changes and abnormalities in choroidal circulation in cases of central serous chorioretinopathy (CSC).METHODS:This was a case control study, we measured the bilateral choroidal thickness in 21 patients with unilateral CSC and 24 eyes of 24 age- and sex-matched normal subjects using enhanced depth imaging optical coherence tomography (EDI-OCT). The choroid was measured from the posterior edge of the retinal pigment epithelium (RPE) to the choroid-scleral junction at 500 µm intervals of a horizontal section from 3 mm temporal to the fovea to 3 mm nasal to the fovea. Paired-samples t-test was conducted to compare mean choroidal thicknesses between symptomatic eyes and fellow eyes of patients. The datum between patients and normal subjects were analyzed by independent-samples t-test. Fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed and the digital images were analyzed in CSC patients.RESULTS:The 21 CSC patients had a mean age of 45.6 years, and 12 patients (57.1%) were male. The choroid in symptomatic eyes was thickest beneath the fovea (519.0 ± 102.5) µm. It was significantly thicker than that in the fellow eyes (439.3 ± 94.1) µm (t = 4.171, P < 0.05). Choroidal thickness in both groups was significantly greater than that in the eyes of age- and sex-matched normal subjects (332.0 ± 67.3) µm (t = 7.125, 4.441; P < 0.05). Choroidal thickness at each of the other 12 points showed a similar tendency (t = 2.544 to 3.819, 4.799 to 7.816, 2.487 to 5.236; P < 0.05). ICGA showed a choroidal filling delay (100%), vessels dilation (90.5%), and focal choroidal hyperfluorescence (100%) surrounding leakage from the RPE in symptomatic eyes. Pigment epithelium detachment with abnormal choroidal circulation was observed in 6 fellow eyes. In 4 symptomatic eyes and 11 fellow eyes, ICGA revealed choroidal hyperfluorescence but FFA showed normal appearance.CONCLUSIONS:CSC seems to be a bilateral eye disease with choroidal focal ischemia followed by vessels congestion and hyperpermeability. EDI OCT is a useful tool for monitoring choroidal thickness changes caused by choroidal vascular hyperpermeability.

OBJECTIVE:To explore the relationship between neuroretinal rim area (RA) /retinal nerve fiber layer (RNFL) thickness and differential light sensitivity (DLS) in visual field in primary open angle glaucoma (POAG).METHODS:Fifty-one eyes of 51 patients with POAG were examined with HRT II, GDx VCC, and Octopus 101 for RA, RNFL thickness, and DLS. Their correlations were evaluated with linear and logarithmic regression models globally and for individual sectors.RESULTS:In all the considered patients, visual field DLS was significantly correlated with neuroretinal RA or RNFL thickness globally and in individual sectors. Logarithmic fits were significantly better than linear fits for the global data and in most sectors. In preperimetric glaucoma, such correlations were weak and linear (R2 = 0.01-0.26). However, in perimetric glaucoma, the correlations were much stronger and curvilinear model gave the better fit (R2 = 0.15-0.84). Neuroretinal RA and RNFL thickness were linearly correlated.CONCLUSION:Neuroretinal RA, RNFL thickness, and DLS in visual field were well correlated in POAG.

OBJECTIVE To describe the clinical features and surgical and visual outcomes in a series of children with rhegmatogenous retinal detachments (RRD). METHODS Retrospective case series of pediatric patients (14 years old or younger) with RRD who underwent primary surgery at a tertiary referral center between May 1995 and May 2006. Patients with perforating ocular trauma were excluded. RESULTS Thirty-six eyes of 33 patients were included in this study. The median age was 12 years, and 26 patients (78.8%) were male. Bilateral RRD was present in 10 patients (30.3%); 22 patients (66.7%) had some form of bilateral ocular pathology. At least one predisposing factor could be identified in 31 (86.1%) of eyes examined. Thirteen eyes (36.1%) experienced trauma, 11 eyes (30.6%) had structural abnormalities, high myopia and eyes underwent previous intraocular surgery were 7 (19.4%) each, and 3 eyes (8.3%) had inflammatory fundus disorders. Macular detachment was found in 28 eyes (77.8%). Median follow-up was 12 months. At the end of follow-up for this report, silicone oil was still in place in 4 eyes. Retinal reattachment was ultimately achieved in 29 of the 32 eyes (90.6%) with a mean of 1.9 surgeries per eye, however, visual recovery was modest. Predictors of a poor visual outcome were: hand motions or worse in preoperative vision (P = 0.001), macular-off retinal detachment (P = 0.003), proliferative vitreoretinopathy grade C or worse (P = 0.000), the need for vitrectomy surgery (P = 0.002), and the use of silicone oil (P = 0.005). CONCLUSIONS Trauma and congenital or developmental anomalies were the most common predisposing factors for pediatric RRD in this series. Retinal reattachment can be achieved in most cases with modern vitreoretinal surgical techniques. Predictors of visual outcomes are similar to those observed in adults. Regular follow-up for children at risk of developing RRD is necessary for early detection.