Risk of Acquired Retinal Detachment in Children with Ocular Coloboma

Abstract

Purpose : Optic nerve (ONC) and chorioretinal (CRC) coloboma are associated with acquired retinal detachment. The risk during early childhood remains unclear. We determined the incidence and age at onset during childhood of acquired retinal detachment in children with coloboma.

Methods : Retrospective cohort study of children with ONC and/or CRC, examined prior to age 18 years between 2009 and 2020 at a pediatric ophthalmology outpatient clinic. Eyes with presumed congenital retinal detachment or retinal dysplasia were excluded. Primary outcomes were incidence and age at diagnosis of acquired retinal detachment.

Results : We studied 387 eyes of 258 children, median age 6.59 years (range 0.04-18 years). Colobomas were bilateral in 129 (50%) children; 288 (74.4%) eyes had ONC, 236 (61%) eyes had CRC, and 137 (35.4%) eyes had both. Among CRC, the macula and periphery were involved in 141 eyes (59.7%) and periphery only in 90 eyes (38.1%). Two eyes of two children had acquired retinal detachment at ages 7 and 14 years (0.52% per eye, 95% CI: 0.06%-1.85%), of which one eye had both ONC and CRC and both eyes had CRC involving the macula and periphery.

Conclusions : Acquired retinal detachment associated with coloboma occurs during childhood but the risk is lower than previously reported. Periodic screening fundus examinations should be performed. The utility of prophylactic laser retinopexy during childhood in eyes with ONC/CRC requires further investigation.

This is a 2021 ARVO Annual Meeting abstract.