Surgical Treatment for the Proliferative Retinal Detachment Associated with Macular Hole in the Morning Glory Syndrome

摘要

Purpose: To evaluate the efficacy of vitrectomy with peripapillary photocoagulation and silicone oil tamponade for the proliferative retinal detachment associated with macular hole in children with morning glory syndrome. Methods: Eight children with morning glory syndrome (mean age 8.0±2.8 years; range 5～13 years) were included; all patients had unilateral eye disease and were initially misdiagnosed as having bilateral squint or amblyopia, with best corrected visual acuity <6/60. Five patients could not cooperate with the fundus examination and one patient had lens opacities.B-ultrasound confirmed that all eight patients had retinal detachment and optic disc dysplasia.All patients underwent standard 3-port pars plana vitrectomy surgery . (20G for three cases and 23G for five cases).At surgery,all patients were confirmed to have morning glory syndrome,macular hole, and proliferative retinal detachment;.two cases had a funnel shaped bulge. All the retinal detachments involved the macular area, and macular hole was detected in the abnormal expansion excavation of the optic disk. The epiretinal membrane and subretinal membrane were completely removed during surgery. Combined photocoagulation in the abnormal expansion excavation of the optic disk, and silicone oil tamponade were also performed. Results:All eyes achieved anatomical resolution of retinal detachment.After follow-ups ranging from eight months to four years,the visual function for all patients was improved by postoperative refractive correction associated with vision training. Best corrected visual acuity was 6/600 to 6/30 at the final follow-up, no retinal detachment recurred, and no silicone oil fluid entered the subretinal space. The silicone oil was successfully removed postoperatively after a mean of 1.5 years. Conclusion:Vitrectomy with peripapillary photocoagulation and silicone oil tamponade is effective in treating the proliferative retinal detachment associated with macular hole in children with morning glory syndrome. (Eye Science 2013;28:7-10)