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Published on: January 26, 2018
Prophylactic juxtapapillary laser photocoagulation in pediatric morning glory syndrome
Yi-Hua Zou1, Kai-Qin She2, Jia-Ning Ren1
1Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
Insights
Prophylactic laser treatment for morning glory syndrome (MGS) in children shows stable anatomic and visual outcomes. This approach may prevent retinal detachment (RD) in MGS patients, though long-term studies are needed.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Retinal Diseases
Background:
- Morning Glory Syndrome (MGS) is a rare congenital anomaly of the optic disc.
- Retinal detachment (RD) is a potential complication of MGS.
- Prophylactic treatment aims to prevent RD in affected eyes.
Purpose of the Study:
- To evaluate the effectiveness of prophylactic juxtapapillary laser photocoagulation in preventing RD in pediatric MGS patients.
- To assess the anatomic and visual outcomes following this treatment.
Main Methods:
- Retrospective review of 24 eyes from 22 pediatric patients (aged 0-15 years) with MGS.
- Treatment involved prophylactic juxtapapillary laser photocoagulation alone.
- Data collected included demographics, ocular examinations, visual acuity, and complications.
Main Results:
- All eyes (100%) showed no obvious RD pre-treatment.
- Anatomic outcomes remained stable during follow-up (mean 27.7 months).
- No severe complications were observed; visual acuity showed varied but stable results.
Conclusions:
- Prophylactic laser treatment for pediatric MGS patients demonstrates relatively stable short-term anatomic and visual outcomes.
- The treatment appears to be a safe option for preventing RD in this cohort.
- Long-term clinical observation is recommended to confirm efficacy and safety.
Aim:
To determine the anatomic and visual outcomes of prophylactic juxtapapillary laser photocoagulation treatment alone in the prevention of retinal detachment (RD) in a cohort of pediatric patients diagnosed with morning glory syndrome (MGS).
Methods:
A total of 24 eyes of 22 consecutive patients aged 0-15y diagnosed with MGS treated with prophylactic juxtapapillary laser photocoagulation alone were reviewed. Data including demographics, ocular examination, anatomic and visual outcomes, following treatment and complications were collected.
Results:
Two patients had bilateral laser treatment and 20 had monocular laser treatment. The age at treatment of 13 (59.1%) patients was less than 12mo. The presenting symptoms included strabismus (6/22, 27.3%), decreased vision (2/22, 9.1%), and routine fundus screening (14/22, 63.6%). Fifteen (68.2%) patients underwent cranial magnetic resonance imaging (MRI) examinations, and 3 of those 15 (20.0%) had abnormal findings in the nervous system. Based on preoperative wide-field fundus photography and B-scan echography, all (100.0%) eyes had no obvious RD. On postoperative 1mo and 6mo and the following follow-ups, the anatomic outcomes of all eyes remained stable. The mean follow-up duration was 27.7±17.5mo. No severe complications were found. Preoperative visual acuity acquired from 2 (9.1%) patients ranged from light perception to 20/200. Postoperative acuity acquired from 11 (50.0%) patients ranged from light perception to 20/125.
Conclusion:
The preliminary anatomic and visual outcomes of prophylactic juxtapapillary laser treatment alone in pediatric MGS patients are relatively stable in a short-term follow-up. Further long-term clinical observation will be needed to confirm its efficacy and safety.
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