Chorioretinal coloboma complications: retinal detachment and choroidal neovascular membrane

Abstract

Purpose:To report the chorioretinal coloboma, and its association with increased risk of retinal detachment (RD) and choroidal neovascularization (CNV).Methods:This retrospective case series included eyes with chorioretinal coloboma diagnosed between 1995 and 2014 with a focus on RD and CNV as related complications. Cases of CNV were managed with laser photocoagulation or intravitreal injection of bevacizumab. For eyes with CNV, therapeutic success was defined as resolution of the subretinal hemorrhage on fundus examination and resolution of the subretinal and intraretinal fluid on optical coherence tomography (OCT). For eyes with RD, anatomic success following surgical intervention was defined as attachment of the retina at the last follow-up visit.Results:Fifty-one eyes of 31 patients with chorioretinal coloboma were identified for review. Bilateral chorioretinal coloboma was present in 64.5% of subjects. RD developed in 15 eyes (29.4%). Among 15 eyes with RD, 4 eyes (27%) had retinal breaks identified within the coloboma, 5 eyes (33%) had retinal breaks outside the coloboma, 2 eyes (13%) showed retinal breaks both inside and outside the coloboma, and in 4 eyes (27%) the causative retinal break was not localized. The overall rate of anatomic success after RD repair was 85.7%. CNV developed in 7 eyes (13.7%) and was located along the margin of the coloboma in all cases. CNV was bilateral in 2 of the 5 affected individuals (40%).Conclusion:RD and CNV were present in a high percentage of eyes with chorioretinal coloboma in these series. The frequent finding of retinal breaks outside the coloboma bed suggests that vitreoretinal interface abnormalities may play a role in development of RD in these eyes.

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

“…In our study, anatomic success after RD repair was 92.3% at the last follow-up visit (1 week after silicon oil removal at 6 months) which is comparable to other reports which had a success rate that ranging from 35 to 100% at the last follow-up visit [3, 7, 11–21].…”

“…Presence of retinal break in the retinal periphery suggests abnormal vitreoretinal adhesion away from the coloboma. Since, in 30.76% of the eyes, retinal break could not be identified, we suggest that prophylactic barrage laser should be given both around the margin of the coloboma and around the vitreous base which is also supported by other studies [3].…”

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

“…In our study, anatomic success after RD repair was 92.3% at the last follow-up visit (1 week after silicon oil removal at 6 months) which is comparable to other reports which had a success rate that ranging from 35 to 100% at the last follow-up visit [3, 7, 11–21].…”

“…Presence of retinal break in the retinal periphery suggests abnormal vitreoretinal adhesion away from the coloboma. Since, in 30.76% of the eyes, retinal break could not be identified, we suggest that prophylactic barrage laser should be given both around the margin of the coloboma and around the vitreous base which is also supported by other studies [3].…”

Cataract Surgery in Eyes with Microphthalmos and/or Uveal Coloboma

“…Adult patients with chorioretinal coloboma have a 29-42% risk of RD [20,21]. In our study, RD was the most common complication in the UC group (incidence of 18.2%), and different types of colobomas (chorioretinal vs. uveal) may account for the differences in RD rates.…”

“…RD is the most common complication of choroidal coloboma [20,21]; therefore, PPPV and gas/silicone oil filling should be combined [14,34]. Combined vitreoretinal surgery is necessary for CBMO [2].…”

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

“…Our cohort showed a PVR grade greater than C in 12 of 31 eyes (38.7%); however, this number did not reach statistical significance as a risk factor for redetachment. Hussain and colleagues 15 reported a 100% incidence of PVR in their cases, whereas Gopal et al 1 had reported a 22.4% incidence of PVR with 9% of eyes having a severe PVR of greater than C3.…”

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

“…In our study, anatomic success after RD repair was 92.3% at the last follow-up visit (1 week after silicon oil removal at 6 months) which is comparable to other reports which had a success rate that ranging from 35 to 100% at the last follow-up visit [3, 7, 11–21].…”

“…Presence of retinal break in the retinal periphery suggests abnormal vitreoretinal adhesion away from the coloboma. Since, in 30.76% of the eyes, retinal break could not be identified, we suggest that prophylactic barrage laser should be given both around the margin of the coloboma and around the vitreous base which is also supported by other studies [3].…”

Cataract Surgery in Eyes with Microphthalmos and/or Uveal Coloboma

“…Adult patients with chorioretinal coloboma have a 29-42% risk of RD [20,21]. In our study, RD was the most common complication in the UC group (incidence of 18.2%), and different types of colobomas (chorioretinal vs. uveal) may account for the differences in RD rates.…”

“…RD is the most common complication of choroidal coloboma [20,21]; therefore, PPPV and gas/silicone oil filling should be combined [14,34]. Combined vitreoretinal surgery is necessary for CBMO [2].…”

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

“…Our cohort showed a PVR grade greater than C in 12 of 31 eyes (38.7%); however, this number did not reach statistical significance as a risk factor for redetachment. Hussain and colleagues 15 reported a 100% incidence of PVR in their cases, whereas Gopal et al 1 had reported a 22.4% incidence of PVR with 9% of eyes having a severe PVR of greater than C3.…”

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

“…In our study, anatomic success after RD repair was 92.3% at the last follow-up visit (1 week after silicon oil removal at 6 months) which is comparable to other reports which had a success rate that ranging from 35 to 100% at the last follow-up visit [3, 7, 11–21].…”

“…Presence of retinal break in the retinal periphery suggests abnormal vitreoretinal adhesion away from the coloboma. Since, in 30.76% of the eyes, retinal break could not be identified, we suggest that prophylactic barrage laser should be given both around the margin of the coloboma and around the vitreous base which is also supported by other studies [3].…”

Cataract Surgery in Eyes with Microphthalmos and/or Uveal Coloboma

“…Adult patients with chorioretinal coloboma have a 29-42% risk of RD [20,21]. In our study, RD was the most common complication in the UC group (incidence of 18.2%), and different types of colobomas (chorioretinal vs. uveal) may account for the differences in RD rates.…”

“…RD is the most common complication of choroidal coloboma [20,21]; therefore, PPPV and gas/silicone oil filling should be combined [14,34]. Combined vitreoretinal surgery is necessary for CBMO [2].…”

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

“…Our cohort showed a PVR grade greater than C in 12 of 31 eyes (38.7%); however, this number did not reach statistical significance as a risk factor for redetachment. Hussain and colleagues 15 reported a 100% incidence of PVR in their cases, whereas Gopal et al 1 had reported a 22.4% incidence of PVR with 9% of eyes having a severe PVR of greater than C3.…”