Rhegmatogenous Retinal Detachment in Children: Clinical Factors Predictive of Successful Surgical Repair.

PURPOSE: To describe presenting clinical features and surgical techniques that are associated with successful surgical repair of pediatric rhegmatogenous retinal detachment (RRD). DESIGN: Retrospective interventional case series. PARTICIPANTS: Two hundred twelve eyes of 191 patients 0 to 18 years of age undergoing surgical repair for RRD between 2001 and 2015 with a minimum follow-up of 3 months. METHODS: Patients were divided into 3 age groups (0-6 years, 7-12 years, and 13-18 years) and comparisons were made using bivariate and multivariate generalized estimating equation models. A mixed means model was used to examine visual acuity in each age group over time. MAIN OUTCOME MEASURES: Complete reattachment of the retina at final follow-up. RESULTS: Of 212 eyes, 166 (78%) achieved total reattachment at final follow-up. Mean follow-up was 36.3 months. Rhegmatogenous retinal detachment associated with Stickler syndrome was more likely to occur in the younger cohorts (odds ratio [OR], 0.45; 95% confidence interval [CI], 0.22-0.91), whereas RRD associated with blunt trauma was more likely to occur in the oldest cohort (OR, 2.3; 95% CI, 1.2-4.4). Subtotal RRD was more likely to be repaired successfully than total RRD (OR, 3.6; 95% CI, 1.5-8.4; P = 0.0100), and eyes with previous vitreoretinal surgery were less likely to undergo successful repair (OR, 0.30; 95% CI, 0.12-0.78; P = 0.0258). There was no significant difference between age groups in the rate of surgical success (P = 0.55). There was a significantly higher success rate with primary scleral buckle (SB; 63%; OR, 2.2; 95% CI, 1.1-4.5) and combined SB plus pars plana vitrectomy (PPV; 68%; OR, 2.3; 95% CI, 1.1-5.1) compared with PPV alone (51%). CONCLUSIONS: Most pediatric patients with RRD achieved complete reattachment with surgery. Success was more common in patients with a subtotal RRD at presentation. Previous vitreoretinal surgery was a risk factor for failure. Younger patients were more likely to demonstrate RRD involving the macula, but there was no difference between age groups in successful reattachment at final follow-up. Primary PPV showed a lower rate of success than SB or combined SB plus PPV.

Pesticide exposure of wild bees and honey bees foraging from field border flowers in intensively managed agriculture areas.

Bees are critical for food crop pollination, yet their populations are declining as agricultural practices intensify. Pollinator-attractive field border plantings (e.g. hedgerows and forb strips) can increase bee diversity and abundance in agricultural areas; however, recent studies suggest these plants may contain pesticides. Pesticide exposure for wild bees remains largely unknown; however, this information is needed to inform agricultural practices and pesticide regulations meant to protect bees. It is important to determine whether border plantings that attract and support pollinators may also deliver pesticides to them. In this study, we collected various samples for pesticide residue analysis, including: multiple species of wild bees, honey bees, flowers from four types of bee-attractive field border plants, and soil. Silicone bands were also utilized as passive aerial samplers of pesticide residues. The five pesticides detected most frequently across all samples were the insecticide bifenthrin, the herbicides thiobencarb, metolaclor, and propanil, and the fungicide fluopyram. We detected the greatest number of parent pesticides in bands (24), followed by soil (21). Pesticides were also detected in field border plant flowers (16), which do not receive direct pesticide applications, and included many products which were not applied to adjacent field crops. Pesticide concentrations were lower in bees than in flowers but higher in bees than in soils. Pesticide residue per bee (ng/bee) increased with increasing wild bee size, though pesticide concentration (ng/g) did not increase. While honey bees and wild bees contained a similar number and concentration of pesticides overall, pesticide mixtures varied by bee type, and included some mixtures known to cause sublethal effects. The results from this study highlight the benefits of measuring more sample types to capture the total exposome of bees, including a greater range of bee species, as well as the need to consider exposure to pesticides at the landscape level.