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Chorioretinal coloboma in a paediatric population
1Department of Ophthalmology, University of Benin Teaching Hospital, Benin City, Nigeria.
Insights
Prophylactic laser photocoagulation significantly reduces the risk of rhegmatogenous retinal detachment (RRD) in children with chorioretinal coloboma. This treatment offers a protective effect, lowering RRD incidence compared to untreated eyes.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Pediatric Eye Care
Background:
- Chorioretinal coloboma presents a significant risk for ocular anomalies and retinal detachment in pediatric patients.
- Rhegmatogenous retinal detachment (RRD) in eyes with coloboma is associated with high complication rates post-surgery.
Purpose of the Study:
- To evaluate the efficacy of laser photocoagulation as a prophylactic measure against RRD in pediatric patients with chorioretinal coloboma.
- To assess the protective role of prophylactic laser treatment in preventing RRD in this high-risk group.
Main Methods:
- An observational case series reviewed 198 pediatric patients (335 eyes) aged 0-15 years with chorioretinal coloboma.
- Data analysis compared RRD prevalence between eyes receiving prophylactic laser photocoagulation and untreated eyes.
Main Results:
- Retinal detachment occurred in 2.9% of eyes with prophylactic laser treatment versus 24.1% in untreated eyes.
- Ocular anomalies were prevalent (87.2%), including iris coloboma (71%) and microphthalmos (19.1%).
- Post-operative complications after RRD surgery were frequent (86.7%), with recurrent detachment being common (53.8%).
Conclusions:
- Prophylactic laser photocoagulation demonstrates a protective effect against RRD in pediatric eyes with chorioretinal coloboma.
- Implementing prophylactic therapy is recommended to mitigate RRD risk and surgical complications in these eyes.
Aim:
To determine the validity of laser photocoagulation as a prophylactic treatment in the prevention of rhegmatogenous retinal detachment (RRD) in a group of paediatric patients presenting with chorioretinal coloboma.
Methods:
Observational case series of consecutive patients aged 0-15 years with chorioretinal coloboma seen in a tertiary eye hospital were reviewed. Data were analysed with SPSS version 16, a P-value of <0.05 was considered significant.
Results:
One hundred and ninety-eight patients (335 eyes) were identified. The prevalence of retinal detachment and ocular anomalies was 17.6 and 87.2%, respectively. Ocular anomalies included iris coloboma (71%), microcornea (45.1%), nystagmus (41.5%), strabismus (21.2%), and microphthalmos (19.1%). The prevalence of retinal detachment was 2.9% in those eyes that received prophylactic laser photocoagulation, whereas the risk of retinal detachment was 24.1% in eyes left untreated. Post-operative complications following retinal detachment surgery occurred in 86.7% eyes; the most frequent being recurrent retinal detachment (53.8%). The mean duration of follow-up was 1.59 ± 0.21 years (0-7 years) and 0.79 ± 0.16 years (0-8 years) in the group that had laser and in those that were treatment naive, respectively.
Conclusions:
Prophylactic laser treatment appears to have a protective effect for the prevention of RRD in eyes with chorioretinal coloboma. Measures towards prophylactic therapy should be instituted to reduce the risk of retinal detachment in choroid colobomatous eyes due to the problems in the management of these retinal detachments.
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