The effect of vitrectomy in the treatment of different types of chorioretinal coloboma with retinal detachment_Chinese Journal of Ocular Fundus Diseases

Authors：

Du Jiao ^1,2 , Li Xiaoli ^1,2 , Zhao Zun ¹ , Wang Dongdong ^1,2 , Dan Handong ^1,2 , Shi Pingling ^1,2 , Huang Zixu ^1,2 , Wang Suhan ³ , Yuan Qiongqiong ^1,2 ,  Song Zongming ^1,2,3

1. Department of Ophthalmology, Zhengzhou University People’s Hospital, Zhengzhou 450003, China;
2. Henan Provincial People’s Hospital, Henan Eye Hospital, Henan Eye Institute, Zhengzhou 450003, China;
3. Department of Ophthalmology, Henan University People’s Hospital, Zhengzhou 450003, China;

Corresponding author：

Song Zongming, Email: szmeyes@126.com

Keywords：

Chorioretinal coloboma; Retinal detachment; Vitrectomy; Silicone oil tamponade

DOI：

10.3760/cma.j.cn511434-20231012-00417

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Objective To observe the efficacy of pars plana vitrectomy (PPV) in the treatment of different types of chorioretinal coloboma with retinal detachment (RD). Methods A single-center, retrospective clinical study. From April 2021 to March 2023, 24 eyes of 23 patients who were diagnosed as chorioretinal coloboma with RD in Henan Provincial Eye Hospital were included in this study. There were 11 males with 12 eyes and 12 females with 12 eyes. The mean age was (33.3±13.7) years old. Best corrected visual acuity (BCVA), spectral domain optical coherence tomography were performed. The BCVA examination was performed using a international standard logarithmic visual acuity chart, which was converted into logarithm of the minimum angle of resolution (logMAR) visual acuity during statistics. According to the types of chorioretinal coloboma, the affected eyes were divided into the coloboma involved the optic disc group and the coloboma not involved the optic disc group, with 15 eyes and 9 eyes. According to whether the RD containing the coloboma area, the affected eyes were divided into RD containing the coloboma area group and the RD not containing the coloboma area group, with 15 eyes and 9 eyes. All eyes underwent standard pars plana three-channel 25G PPV, retinal laser photocoagulation combined with silicone oil tamponade. The follow-up time after surgery was (19.5±16.3) months. The last follow-up was the time point for efficacy determination. The retinal reattachment, BCVA recovery and postoperative complications were observed. Paired t-test or t test was performed for comparison of quantitative data. Fisher's exact test was performed for comparison of qualitative data. Results At the last follow-up, retinal reattachment was achieved in 20 eyes (83.3%, 20/24). The logMAR BCVA of the coloboma involved the optic disc group before and after surgery were 1.85±0.62 and 1.71±0.71, the difference was no significant (t=0.845, P=0.412). The logMAR BCVA of the coloboma not involved the optic disc group before and after surgery were 1.75±0.45 and 0.84±0.26, the difference was statistically significant (t=6.153, P＜0.001). The improvement of BCVA in the coloboma not involved the optic disc group was significantly higher than that in the coloboma involved the optic disc group after surgery, with statistically significant differences (t=3.024, P=0.006). There was no significant difference in the retinal reattachment rate between the two groups (P=0.615). There was no significant difference in the retinal reattachment rate between the RD containing the coloboma area group and the RD not containing the coloboma area group (P=0.259). Postoperative complications included elevated intraocular pressure in five eyes, cataract progression in ten eyes, recurrent RD in two eyes, bullous keratopathy in one eye and band-shaped keratopathy in one eye. Conclusion PPV combined with silicone oil tamponade is safe and effective in the treatment of chorioretinal coloboma with RD, the improvement of visual acuity in the coloboma not involved the optic disc group is better than that in the coloboma involved the optic disc group after surgery.

Citation： Du Jiao, Li Xiaoli, Zhao Zun, Wang Dongdong, Dan Handong, Shi Pingling, Huang Zixu, Wang Suhan, Yuan Qiongqiong, Song Zongming. The effect of vitrectomy in the treatment of different types of chorioretinal coloboma with retinal detachment. Chinese Journal of Ocular Fundus Diseases, 2023, 39(12): 969-973. doi: 10.3760/cma.j.cn511434-20231012-00417 Copy

1.	Wang K, Hilton GF. Retinal detachment associated with coloboma of the choroid[J]. Trans Am Ophthalmol Soc, 1985, 83: 49-62.
2.	Hussain RM, Abbey AM, Shah AR, et al. Chorioretinal coloboma complications: retinal detachment and choroidal neovascular membrane[J]. J Ophthalmic Vis Res, 2017, 12(1): 3-10. DOI: 10.4103/2008-322x.200163.
3.	Schulze-Bonsel K, Feltgen N, Burau H, et al. Visual acuities "hand motion" and "counting fingers" can be quantified with the freiburg visual acuity test[J]. Invest Ophthalmol Vis Sci, 2006, 47(3): 1236-1240. DOI: 10.1167/iovs.05-0981.
4.	Lingam G, Sen AC, Lingam V, et al. Ocular coloboma-a comprehensive review for the clinician[J]. Eye (Lond), 2021, 35(8): 2086-2109. DOI: 10.1038/s41433-021-01501-5.
5.	Pal N, Azad RV, Sharma YR. Long-term anatomical and visual outcome of vitreous surgery for retinal detachment with choroidal coloboma[J]. Indian J Ophthalmol, 2006, 54(2): 85-88. DOI: 10.4103/0301-4738.25827.
6.	Jesberg DO, Schepens CL. Retinal detachment associated with coloboma of the choroid[J]. Arch Ophthalmol, 1961, 65: 163-173. DOI: 10.1001/archopht.1961.01840020165003.
7.	Rishi E, Rishi P, Govindarajan MV. Pneumatic retinopexy for the treatment of shallow retinal detachment caused by a retinal break in the intercalary membrane of macula sparing retinochoroidal coloboma[J]. Retin Cases Brief Rep, 2016, 10(2): 187-190. DOI: 10.1097/icb.0000000000000222.
8.	Gopal L, Kini MM, Badrinath SS, et al. Management of retinal detachment with choroidal coloboma[J]. Ophthalmology, 1991, 98(11): 1622-1627. DOI: 10.1016/s0161-6420(91)32075-x.
9.	Hocaoglu M, Karacorlu M, Ersoz MG, et al. Outcomes of vitrectomy with silicone oil tamponade for management of retinal detachment in eyes with chorioretinal coloboma[J]. Retina, 2019, 39(4): 736-742. DOI: 10.1097/iae.0000000000002014.
10.	Suwal B, Paudyal G, Thapa R, et al. A study on pattern of retinal detachment in patients with choroidal coloboma and its outcome after surgery at a tertiary eye hospital in nepal[J/OL]. J Ophthalmol, 2019, 2019: 7390852[2019-04-21]. https://pubmed.ncbi.nlm.nih.gov/31143474/. DOI: 10.1155/2019/7390852.
11.	Shenoy P, Katre PS, Kohli GM, et al. Coloboma associated retinal detachment: anatomical and functional results in the era of microincision vitrectomy surgery with an evaluation of risk factors for a recurrence[J]. Indian J Ophthalmol, 2022, 70(7): 2498-2504. DOI: 10.4103/ijo.IJO_2615_21.
12.	Gopal L, Khan B, Jain S, et al. A clinical and optical coherence tomography study of the margins of choroidal colobomas[J]. Ophthalmology, 2007, 114(3): 571-580. DOI: 10.1016/j.ophtha.2006.06.048.
13.	Kannan NB, Sen S, Kohli P, et al. Clinical spectrum and long-term anatomical and functional outcomes of pars plana vitrectomy in retinal detachments associated with choroidal coloboma[J]. J Vitreoretin Dis, 2020, 4(2): 103-109. DOI: 10.1177/2474126 419893542.
14.	Uhumwangho OM, Jalali S. Chorioretinal coloboma in a paediatric population[J]. Eye (Lond), 2014, 28(6): 728-733. DOI: 10.1038/eye.2014.61.
15.	Ramezani A, Dehghan MH, Rostami A, et al. Outcomes of retinal detachment surgery in eyes with chorioretinal coloboma[J]. J Ophthalmic Vis Res, 2010, 5(4): 240-245.

1. Wang K, Hilton GF. Retinal detachment associated with coloboma of the choroid[J]. Trans Am Ophthalmol Soc, 1985, 83: 49-62.
2. Hussain RM, Abbey AM, Shah AR, et al. Chorioretinal coloboma complications: retinal detachment and choroidal neovascular membrane[J]. J Ophthalmic Vis Res, 2017, 12(1): 3-10. DOI: 10.4103/2008-322x.200163.
3. Schulze-Bonsel K, Feltgen N, Burau H, et al. Visual acuities "hand motion" and "counting fingers" can be quantified with the freiburg visual acuity test[J]. Invest Ophthalmol Vis Sci, 2006, 47(3): 1236-1240. DOI: 10.1167/iovs.05-0981.
4. Lingam G, Sen AC, Lingam V, et al. Ocular coloboma-a comprehensive review for the clinician[J]. Eye (Lond), 2021, 35(8): 2086-2109. DOI: 10.1038/s41433-021-01501-5.
5. Pal N, Azad RV, Sharma YR. Long-term anatomical and visual outcome of vitreous surgery for retinal detachment with choroidal coloboma[J]. Indian J Ophthalmol, 2006, 54(2): 85-88. DOI: 10.4103/0301-4738.25827.
6. Jesberg DO, Schepens CL. Retinal detachment associated with coloboma of the choroid[J]. Arch Ophthalmol, 1961, 65: 163-173. DOI: 10.1001/archopht.1961.01840020165003.
7. Rishi E, Rishi P, Govindarajan MV. Pneumatic retinopexy for the treatment of shallow retinal detachment caused by a retinal break in the intercalary membrane of macula sparing retinochoroidal coloboma[J]. Retin Cases Brief Rep, 2016, 10(2): 187-190. DOI: 10.1097/icb.0000000000000222.
8. Gopal L, Kini MM, Badrinath SS, et al. Management of retinal detachment with choroidal coloboma[J]. Ophthalmology, 1991, 98(11): 1622-1627. DOI: 10.1016/s0161-6420(91)32075-x.
9. Hocaoglu M, Karacorlu M, Ersoz MG, et al. Outcomes of vitrectomy with silicone oil tamponade for management of retinal detachment in eyes with chorioretinal coloboma[J]. Retina, 2019, 39(4): 736-742. DOI: 10.1097/iae.0000000000002014.
10. Suwal B, Paudyal G, Thapa R, et al. A study on pattern of retinal detachment in patients with choroidal coloboma and its outcome after surgery at a tertiary eye hospital in nepal[J/OL]. J Ophthalmol, 2019, 2019: 7390852[2019-04-21]. https://pubmed.ncbi.nlm.nih.gov/31143474/. DOI: 10.1155/2019/7390852.
11. Shenoy P, Katre PS, Kohli GM, et al. Coloboma associated retinal detachment: anatomical and functional results in the era of microincision vitrectomy surgery with an evaluation of risk factors for a recurrence[J]. Indian J Ophthalmol, 2022, 70(7): 2498-2504. DOI: 10.4103/ijo.IJO_2615_21.
12. Gopal L, Khan B, Jain S, et al. A clinical and optical coherence tomography study of the margins of choroidal colobomas[J]. Ophthalmology, 2007, 114(3): 571-580. DOI: 10.1016/j.ophtha.2006.06.048.
13. Kannan NB, Sen S, Kohli P, et al. Clinical spectrum and long-term anatomical and functional outcomes of pars plana vitrectomy in retinal detachments associated with choroidal coloboma[J]. J Vitreoretin Dis, 2020, 4(2): 103-109. DOI: 10.1177/2474126 419893542.
14. Uhumwangho OM, Jalali S. Chorioretinal coloboma in a paediatric population[J]. Eye (Lond), 2014, 28(6): 728-733. DOI: 10.1038/eye.2014.61.
15. Ramezani A, Dehghan MH, Rostami A, et al. Outcomes of retinal detachment surgery in eyes with chorioretinal coloboma[J]. J Ophthalmic Vis Res, 2010, 5(4): 240-245.

Chinese Journal of Ocular Fundus Diseases

The effect of vitrectomy in the treatment of different types of chorioretinal coloboma with retinal detachment

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