Lincoff’s Rule Is Not Followed in Pediatric Rhegmatogenous Retinal Detachments

ABSTRACT

Purpose

To validate Lincoff’s rules (LRs) in cases of rhegmatogenous retinal detachment (RRD) in the pediatric age group and to identify factors in cases LR was not followed.

Method

This was a retrospective study where 98 pediatric patients with RRD were identified through surgery records. Forty case sheets with complete record of ocular examination and surgical findings were analyzed. Visible or suspected preoperative retinal break identified using the LR and actual intraoperative retinal break noted was recorded. Validity of LR was tested and analysed.

Result

The median age of the study participants was 11 years ranging from 5 to 18 years. There were 35 (88%) boys and 5 (12%) girls in the study. Myopia was noted in 13 (33%) eyes and in 21 (53%) eyes, there was a history of preexisting ocular trauma. Moderate degree of agreement with a Cohen’s kappa 0.41 was noted with regards to LR validity in pediatric RRD. LR was validated in non-myopic eyes (p = 0.022), inferior RD (p < 0.001), and those with anteriorly located retinal breaks (p < 0.001). Other attributes such as history of trauma (p = 0.08), lens status (p = 0.489), macula sparing RRD (p = 0.882), and chronicity of RRD (p = 0.612) did not have a statistically significant association with validity of LR. Multivariate logistic regression analysis identified the presence of anterior retinal break (p = 0.011) and presence of inferior RD (p = 0.022) as the two most important attributes in a RD for agreement of LR.

Conclusion

LRs fail to accurately identify the exact location of the retinal break due to its posterior location and absence of posterior vitreous detachment in most cases with pediatric RRDs.

KEYWORDS:

• Lincoff‘s rule
• pediatric
• retinal break
• rhegmatogenous retinal detachment

Availability of Data and Materials

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Authors’ Contributions

RV, JC, and NKY – Conceptualizing the study, data acquisition, analyzing the data, statistics and results, interpreting the findings, writing and reviewing the manuscript. RS, VP, RM, and SS – Data acquisition and analyzing the data.

Disclosure Statement

No potential conflict of interest was reported by the authors.

Ethics Approval and Consent to Participate

Approval was obtained from Narayana Nethralaya Institutional Review Board and Ethics committee (C-2021-03-003).

Additional information

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.