A Study on Pattern of Retinal Detachment in Patients with Choroidal Coloboma and Its Outcome after Surgery at a Tertiary Eye Hospital in Nepal

Abstract

Background. To review the pattern of retinal detachment (RD) in patients with choroidal coloboma and type of reattachment surgery performed and to study its outcome in terms of retinal reattachment, visual acuity, and postsurgical complications. Methods. Observational case series of a single tertiary eye institution of 13 eyes having choroidal coloboma with RD done from January 2015 to June 2017. Results. Mean age of presentation was 29.3 years (Range 14–60 years). Males were two times more affected than females (2.25 : 1). The overall rate of anatomic success achieved after RD repair and silicon oil removal at 6 months was 92.3% (12/13 eyes). Following surgery, visual acuity improved in 6 out of 11 eyes (54.54%), remained unchanged in 4 eyes (36.36%), and worsened in 1 eye (9.1%). The most common complication following surgery was secondary glaucoma in 30.7% (4/11 eyes). Conclusion. The overall anatomic success rate of retina reattachment surgery in colobomatous eye is good, and the visual outcome following surgery can improve in majority of the cases or may remain same in few cases. Hence, timely surgery is advocated. But careful follow-up is required as the risk of postoperative complications is also high.

Clinical Spectrum and Long-Term Anatomical and Functional Outcomes of Pars Plana Vitrectomy in Retinal Detachments Associated With Choroidal Coloboma

“…23 The other study by Suwal and colleagues involving 12 eyes undergoing surgery mentioned a follow-up period of 6 months, which is again inadequate to properly assess the final outcome. 24 In our series, 45.2% of eyes developed redetachment, with 50% of them showing redetachment within 6 months after the first vitrectomy surgery. Several of these cases required SOIs to be repeated for redetachments.…”

Clinical Spectrum and Long-Term Anatomical and Functional Outcomes of Pars Plana Vitrectomy in Retinal Detachments Associated With Choroidal Coloboma

“…23 The other study by Suwal and colleagues involving 12 eyes undergoing surgery mentioned a follow-up period of 6 months, which is again inadequate to properly assess the final outcome. 24 In our series, 45.2% of eyes developed redetachment, with 50% of them showing redetachment within 6 months after the first vitrectomy surgery. Several of these cases required SOIs to be repeated for redetachments.…”

The Outcome of Surgeries Performed for Retinal Detachment Associated with Chorioretinal Coloboma

“…Previously, such types of retinal detachments were treated with the external approach by scleral buckling techniques, but the overall success rate was not satisfactory because of the relatively greater diculty in nding and closing the causative breaks with this approach. 1,2 Schepens et al tried these coloboma cases by draining the sub-retinal uid (SRF), followed by cryopexy, photocoagulation, or both, but still, the overall success rate was not great. 3,4 A radial sponge was also tried with somehow better results but inducing very high astigmatism.…”

Real-world clinical and molecular management of 50 prospective patients with microphthalmia, anophthalmia and/or ocular coloboma

“…An RD rate of 9% was identified in this cohort ranging from the first to the third decade; this varies widely in the literature (2.4%–42%) for patients with chorioretinal coloboma. 28 29 Guidance regarding screening intervals and overall screening period is not clear and it is challenging to be prescriptive for rare and heterogeneous groups of patients with variable visual potentials. From this data, patients suitable for vitreoretinal surgery should be screened during their preverbal years and parents are given advice about monitoring for change in visual behaviour between intervals.…”

Clinical Spectrum and Long-Term Anatomical and Functional Outcomes of Pars Plana Vitrectomy in Retinal Detachments Associated With Choroidal Coloboma

“…23 The other study by Suwal and colleagues involving 12 eyes undergoing surgery mentioned a follow-up period of 6 months, which is again inadequate to properly assess the final outcome. 24 In our series, 45.2% of eyes developed redetachment, with 50% of them showing redetachment within 6 months after the first vitrectomy surgery. Several of these cases required SOIs to be repeated for redetachments.…”

The Outcome of Surgeries Performed for Retinal Detachment Associated with Chorioretinal Coloboma

“…Previously, such types of retinal detachments were treated with the external approach by scleral buckling techniques, but the overall success rate was not satisfactory because of the relatively greater diculty in nding and closing the causative breaks with this approach. 1,2 Schepens et al tried these coloboma cases by draining the sub-retinal uid (SRF), followed by cryopexy, photocoagulation, or both, but still, the overall success rate was not great. 3,4 A radial sponge was also tried with somehow better results but inducing very high astigmatism.…”

Real-world clinical and molecular management of 50 prospective patients with microphthalmia, anophthalmia and/or ocular coloboma

“…An RD rate of 9% was identified in this cohort ranging from the first to the third decade; this varies widely in the literature (2.4%–42%) for patients with chorioretinal coloboma. 28 29 Guidance regarding screening intervals and overall screening period is not clear and it is challenging to be prescriptive for rare and heterogeneous groups of patients with variable visual potentials. From this data, patients suitable for vitreoretinal surgery should be screened during their preverbal years and parents are given advice about monitoring for change in visual behaviour between intervals.…”

Clinical Spectrum and Long-Term Anatomical and Functional Outcomes of Pars Plana Vitrectomy in Retinal Detachments Associated With Choroidal Coloboma

“…23 The other study by Suwal and colleagues involving 12 eyes undergoing surgery mentioned a follow-up period of 6 months, which is again inadequate to properly assess the final outcome. 24 In our series, 45.2% of eyes developed redetachment, with 50% of them showing redetachment within 6 months after the first vitrectomy surgery. Several of these cases required SOIs to be repeated for redetachments.…”

The Outcome of Surgeries Performed for Retinal Detachment Associated with Chorioretinal Coloboma

“…Previously, such types of retinal detachments were treated with the external approach by scleral buckling techniques, but the overall success rate was not satisfactory because of the relatively greater diculty in nding and closing the causative breaks with this approach. 1,2 Schepens et al tried these coloboma cases by draining the sub-retinal uid (SRF), followed by cryopexy, photocoagulation, or both, but still, the overall success rate was not great. 3,4 A radial sponge was also tried with somehow better results but inducing very high astigmatism.…”

Real-world clinical and molecular management of 50 prospective patients with microphthalmia, anophthalmia and/or ocular coloboma

“…An RD rate of 9% was identified in this cohort ranging from the first to the third decade; this varies widely in the literature (2.4%–42%) for patients with chorioretinal coloboma. 28 29 Guidance regarding screening intervals and overall screening period is not clear and it is challenging to be prescriptive for rare and heterogeneous groups of patients with variable visual potentials. From this data, patients suitable for vitreoretinal surgery should be screened during their preverbal years and parents are given advice about monitoring for change in visual behaviour between intervals.…”