Does paediatric rhegmatogenous retinal detachment (RRD) obey Lincoff’s rule (LR)?
Reviewed by Su Young

This was a retrospective study where 98 paediatric patients with RRD were identified through surgery records. Forty case sheets with complete record of ocular examination and surgical findings were analysed. 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. The median age of the study participants was 11 years ranging from five to 18 years. There were 35 (88%) boys and five (12%) girls in the study. Myopia was noted in 13 (33%) eyes and in 21 (53%) eyes, and there was a history of pre-existing ocular trauma. Moderate degree of agreement with a Cohen’s kappa 0.41 was noted with regards to LR validity in paediatric RRD. LR was validated in non-myopic eyes (p=0.022), inferior RRD (p<0.001), and those with anteriorly located retinal breaks (p<0.001). 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 RRD (p=0.022) as the two most important attributes in a RRD for agreement of LR. The authors conclude that 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 paediatric RRDs.

Lincoff’s rule is not followed in pediatric rhegmatogenous retinal detachments.
Venkatesh R, Sangoram R, Prabhu V, et al.
SEMINARS IN OPHTHALMOLOGY
2022;37(6):707-10.