In the realm of pediatric ophthalmology, the intricate tapestry of conditions that lead to surgical intervention is both compelling and complex. A groundbreaking study recently published in the American Journal of Ophthalmology has cast a new light on the patterns of vitreoretinal diseases that necessitate pediatric vitrectomy—the surgical removal of the vitreous humor in the eye. The article, titled “Contemporary Patterns and Underlying Causes of Vitrectomy in Pediatric and Adolescent Patients: A Nationwide, Population-Based Analysis,” provides a detailed examination of the incidence, causes, and trends of such conditions in patients under the age of 20 in South Korea using an extensive national health claims database.
The significance of this study lies not merely in its immediate findings, but also in its implications for future research and potential shifts in public health strategies. Authored by Ju-Yeun Lee, Kyungsik Kim, and Kunho Bae, the study’s findings were made available ahead of print on January 14, 2024, with the finalized publication following soon after on January 12.
The study reveals a promising decrease in the incidence of pars plana vitrectomy (PPV) in adolescents over time, alongside nuanced variations in the reasons for surgery between different age groups and genders. Through an exhaustive analysis of the data from the Korean National Health Claims database, spanning 11 years from 2009 to 2020, researchers have gained unprecedented insights into the etiological landscape of these serious eye conditions.
From the total cohort of 1,913 patients identified, with categories spanning infants, pediatric patients, and adolescents, several important findings have emerged. The overall cumulative incidence of PPV stood at 21.42 per 100,000 individuals, with a notably higher rate in males compared to females—a disparity of 2.4 times. Furthermore, the incidence of eye trauma necessitating PPV surgery was also higher in males, particularly those 5 years and older, wherein the incidence of PPV almost halved from 2011 to 2020.
Diving deeper into the causes for PPV, retinopathy of prematurity (ROP) was identified as the most prevalent etiology in infants with a rate of 72%, while retinal detachment (RD) took the lead among those aged 5-19, with a 63% rate. Myopia and atopic dermatitis also emerged as common comorbidities, affecting 30.3% and 31.8% of the patients respectively.
The implications of this research are far-reaching, with the authors suggesting that the decrease in PPV surgeries among adolescents could be attributed to improved preventive measures, heightened public awareness, or advancements in technology that mitigate the progression of vitreoretinal diseases.
Keywords
1. Pediatric Vitrectomy
2. Retinopathy of Prematurity
3. Retinal Detachment
4. Eye Health Trends
5. Pars Plana Vitrectomy
For those interested in further exploring the intricate details of the study, the publication can be found under the DOI: 10.1016/j.ajo.2024.01.002. As a bibliographical reference, it has been cataloged as S0002-9394(24)00004-7 in the database.
References
1. Lee, J.-Y., Kim, K., & Bae, K. (2024). Contemporary Patterns and Underlying Causes of Vitrectomy in Pediatric and Adolescent Patients: A Nationwide, Population-Based Analysis. American Journal of Ophthalmology, 1879-1891. https://doi.org/10.1016/j.ajo.2024.01.002
2. American Society of Retina Specialists. (n.d.). What is Vitrectomy? Retrieved from https://www.asrs.org
3. Early Treatment for Retinopathy of Prematurity Cooperative Group. (2003). Revised indications for the treatment of retinopathy of prematurity. Archives of Ophthalmology, 121(12), 1684-1694.
4. Wilkinson CP. (1997). Evidence-based analysis of prophylactic treatment of asymptomatic retinal breaks and lattice degeneration. Ophthalmology, 104(9), 1471-1475.
5. Virgili, G., Michelessi, M., Parodi, M. B., Bacherini, D., & Evans, J. R. (2015). Laser treatment for retinopathy of prematurity. Cochrane Database of Systematic Reviews, (5), CD004740. https://doi.org/10.1002/14651858.cd004740.pub3
As always, the declaration of competing interests is critical to ensure the integrity of the study. The authors have disclosed no conflicting relationships, further solidifying the credibility of their findings.
This study not only broadens our understanding of vitreoretinal diseases in the younger population but also underscores the need for targeted patient education and specific etiological examination based on age and sex. With this knowledge in hand, health care practitioners and policymakers can better tailor their approaches to address the unique needs of pediatric and adolescent patients facing such challenging conditions.