Sociodemographic factors affecting presentation in pediatric rhegmatogenous retinal detachment

Purpose: Evaluate impact of sociodemographic factors with visual acuity (VA) and macula status at presentation in pediatric rhegmatogenous retinal detachment (RRD) and with single surgery anatomic success (SSAS), postoperative VA and 1-year lost to follow-up (LTFU). Methods: Retrospective review of patients <18 years who presented with RRD between 2015-2024. Data on demographics (age, gender, race, ethnicity), area deprivation index (ADI), insurance status, rurality of residence and travel time to clinic were recorded. VA was recorded at presentation and 12-month postoperative visit. Regression analysis was used to evaluate the relationship of sociodemographic factors with macula status at presentation, presenting VA, SSAS, 12-month postoperative VA and LTFU. Results: Of the 229 pediatric patients who presented with RRD, 33.6% (N=77/229) were macula-on at presentation. The mean (± standard deviation) patient age was 12.9 (± 4.1) years and 58% were male. On multivariable analysis, older age (OR 1.17, 95% confidence interval: 1.07-1.28, p<0.001) was the only factor predictive of macula-on status at presentation. Females (OR 2.31, 95% CI: 1.18-4.56, p=0.02) versus males were more likely to have better vision (VA 20/40 or better) at presentation. The SSAS was 85.9%, and macula-off status at presentation (OR 4.47, 95% CI: 1.21-16.46; p=0.02) was associated with increased likelihood of needing reoperation. The 1-year LTFU rate was 46%, with insured status associated with decreased odds of LTFU. Conclusions: Older age and female gender were associated with more favorable presentation among pediatric RRDs and insurance status influenced LTFU. ADI and travel time did not influence presentation or postoperative outcomes in pediatric RRDs.