Abstract

Purpose: To determine the clinical features of traumatic ciliochoroidal detachment(CCD), and to evaluate the surgical outcomes.

Methods: We retrospectively reviewed the records of 37 con- secutive patients with traumatic CCD who underwent surgical procedures, including ciliary body suturing, transscleral cy- clophotocoagulation,and cyclocryopexy. A complete ocular examination was performed at presurgery and at periodical post-surgery follow-ups. We compared visual acuity(VA), intraocular pressure(IOP), and morphologic changes with UBM among the different surgical procedures at the presurgery and periodical follow-ups.

Results: The mean IOP was 6.62 mmHg,and the median VA was 20/200 at baseline. The mean final IOP was 11.03 mmHg, and the final median VA improved to 20/50. IOPs were significantly different in post-surgery compared with those at baseline(P=0.000) among the ciliary body suturing, cyclophotocoagulation, and cyclocryopexy groups. However, no significant differences were noted at each follow-up among the 3 groups(P>0.05). The post-surgical morphological figures consisted of complete reattachment,partial reattachment, and the complete detachment.Cyclocryopexy(71.4%), suturing(68.4%), and cyclophotocoagulation(63.6%) produced similar surgical outcomes of the complete reattachment based on UBM images.

Conclusion: Prompt treatment and periodic follow-ups are necessary after traumatic CCD, based on accurate dimensions and configuration by UBM. The appropriate choice of surgical procedures is pivotal for an optimal outcome. (Eye Science 2013; 28: 124-128)

Abstract

Purpose: To determine the clinical features of traumatic ciliochoroidal detachment(CCD), and to evaluate the surgical outcomes.

Methods: We retrospectively reviewed the records of 37 con- secutive patients with traumatic CCD who underwent surgical procedures, including ciliary body suturing, transscleral cy- clophotocoagulation,and cyclocryopexy. A complete ocular examination was performed at presurgery and at periodical post-surgery follow-ups. We compared visual acuity(VA), intraocular pressure(IOP), and morphologic changes with UBM among the different surgical procedures at the presurgery and periodical follow-ups.

Results: The mean IOP was 6.62 mmHg,and the median VA was 20/200 at baseline. The mean final IOP was 11.03 mmHg, and the final median VA improved to 20/50. IOPs were significantly different in post-surgery compared with those at baseline(P=0.000) among the ciliary body suturing, cyclophotocoagulation, and cyclocryopexy groups. However, no significant differences were noted at each follow-up among the 3 groups(P>0.05). The post-surgical morphological figures consisted of complete reattachment,partial reattachment, and the complete detachment.Cyclocryopexy(71.4%), suturing(68.4%), and cyclophotocoagulation(63.6%) produced similar surgical outcomes of the complete reattachment based on UBM images.

Conclusion: Prompt treatment and periodic follow-ups are necessary after traumatic CCD, based on accurate dimensions and configuration by UBM. The appropriate choice of surgical procedures is pivotal for an optimal outcome. (Eye Science 2013; 28: 124-128)

Purpose: To evaluate the prevalence of plateau iris diagnosed by ultrasound biomicroscopy after laser peripheral iridotomy in Whites as compared to Asians in a U. S. clinic setting.
Methods: This was a prospective, observational study of narrow angle patients(n=55)who underwent laser peripheral iridotomy. Ultrasound biomicroscopy was performed in 4 quadrants of only one eye of each patient 4~6 weeks before and after surgery. The images were randomized and interpreted qualitatively by a single observer. Plateau iris was diagnosed in eyes with persistent appositional angles after laser peripheral iridotomy when at least 2 quadrants fulfilled the following criteria:1. The ciliary process was directed anteriorly. 2. The ciliary sulcus was absent. 3. The central iris plane was flat.
Results: Twenty eight subjects (50.1%)were Whites, and 27 subjects (49.0%)were Asians. Plateau iris was assessed in 18 subjects (32.7%):9 of 28 Whites (32.1%)and 9 of 27 Asians (33.3%). The proportion of plateau iris did not differ between Whites and Asians (P>0.99).
Conclusion: The prevalence of plateau iris did not differ between Whites and Asians.  Both groups had a substantial proportion of narrow angle patients with this clinical entity. (Eye Science  2012:27:13-18)

Purpose: To evaluate the prevalence of plateau iris diagnosed by ultrasound biomicroscopy after laser peripheral iridotomy in Whites as compared to Asians in a U. S. clinic setting.
Methods: This was a prospective, observational study of narrow angle patients(n=55)who underwent laser peripheral iridotomy. Ultrasound biomicroscopy was performed in 4 quadrants of only one eye of each patient 4~6 weeks before and after surgery. The images were randomized and interpreted qualitatively by a single observer.  Plateau iris was diagnosed in eyes with persistent appositional angles after laser peripheral iridotomy when at least 2 quadrants fulfilled the following criteria:1. The ciliary process was directed anteriorly. 2. The ciliary sulcus was absent. 3. The central iris plane was flat.
Results: Twenty eight subjects(50. 1%)were Whites, and 27 subjects(49. 0%)were Asians. Plateau iris was assessed in 18 subjects(32. 7%):9 of 28 Whites(32. 1%)and 9 of 27 Asians (33. 3%). The proportion of plateau iris did not differ between Whites and Asians(P>0. 99).
Conclusion: The prevalence of plateau iris did not differ between Whites and Asians.  Both groups had a substantial proportion of narrow angle patients with this clinical entity. (Eye Science  2012:27:13-18)

Abstract

Purpose: To perform ophthalmic examinations to evaluate the ocular characteristics of children living in the Tibet plateau and diagnosed with congenital heart disease.

Methods: Children with congenital heart disease underwent a conventional ocular examination including distant acuity test, slitlamp examination, fundus examination, non-contact intraocular pressure measurement,measurement of corneal thickness, and fundus photography.

Results: Forty-two Tibetan children, aged between 4 and 18 years and diagnosed with congenital heart disease, were enrolled in this study. The percentage of low visual acuity was  4.76%, mean intraocular pressure was (13.67±2.15) mmHg, average corneal thickness was (492.55±33.79) μm, 96.43%  had an anterior chamber depth of 1/2 corneal thickness (CT), and 35.7% had an obvious fundus vascular tortuosity.

Conclusion:This study adds to the understanding of the ocular status of the population living in the Tibet plateau, thereby offering clinical evidence for the prevention and treatment of eye diseases in this area.

Abstract

Purpose: To perform ophthalmic examinations to evaluate the ocular characteristics of children living in the Tibet plateau and diagnosed with congenital heart disease.

Methods: Children with congenital heart disease underwent a conventional ocular examination including distant acuity test, slitlamp examination, fundus examination, non-contact intraocular pressure measurement,measurement of corneal thickness, and fundus photography.

Results: Forty-two Tibetan children, aged between 4 and 18 years and diagnosed with congenital heart disease, were enrolled in this study. The percentage of low visual acuity was  4.76%, mean intraocular pressure was (13.67±2.15) mmHg, average corneal thickness was (492.55±33.79) μm, 96.43%  had an anterior chamber depth of 1/2 corneal thickness (CT), and 35.7% had an obvious fundus vascular tortuosity.

Conclusion:This study adds to the understanding of the ocular status of the population living in the Tibet plateau, thereby offering clinical evidence for the prevention and treatment of eye diseases in this area.

Abstract

Purpose: To investigate the clinical significance of 24-hour monitoring of intraocular pressure (IOP) .

Methods: A total of 571 cases (1055 eyes) undergoing 24- hour monitoring of IOP in the Second People's Hospital of Zhengzhou between June 2012 and March 2013 were retrospectively analyzed.

Results: Among all 1055 eyes,298 had suspected glaucoma (28.2%); 390 (37.0%) were diagnosed with glaucoma but re ceived no treatment (312 with primary open angle glaucoma (POAG) and 78 with primary angle closure glaucoma (PACG)); 215 (20.4%) were diagnosed with glaucoma and received medical treatment; 132(12.5%) underwent glaucoma filtration surgery;and there were 20 others. Through 24-hour IOP monitoring, 104 among 298 cases with suspected glaucoma were diagnosed with normal tension glaucoma (NTG), 110 with POAG, and 28 with the secondary glaucomaCondition assessment and treatment plans were presented for 390 glaucoma cases receiving no treatment. Adjustment was made in the medical treatment of 138 eyes. Following glaucoma iltration surgery, 52 eyes received clinical advice on subsequent treatment.

Conclusion: The simplified 24-hour IOP monitoring method is readily accepted by patients, which is of great significance for providing guidance on the diagnosis of glaucoma and the assessment of the efficacy of glaucoma surgery. However, one-time 24-hour IOP monitoring is not sufficiently efficacious to make a definite diagnosis of NTG. Therefore,long-term follow-up and repeated 24-hour IOP monitoring are required to diagnose NTG, along with a variety of related examinations. (Eye Science 2013;28:119-123)

Abstract

Purpose: To investigate the clinical significance of 24-hour monitoring of intraocular pressure (IOP) .

Methods: A total of 571 cases (1055 eyes) undergoing 24- hour monitoring of IOP in the Second People's Hospital of Zhengzhou between June 2012 and March 2013 were retrospectively analyzed.

Results: Among all 1055 eyes,298 had suspected glaucoma (28.2%); 390 (37.0%) were diagnosed with glaucoma but re ceived no treatment (312 with primary open angle glaucoma (POAG) and 78 with primary angle closure glaucoma (PACG)); 215 (20.4%) were diagnosed with glaucoma and received medical treatment; 132(12.5%)underwent glaucoma filtration surgery; and there were 20 others. Through 24-hour IOP monitoring, 104 among 298 cases with suspected glaucoma were diagnosed with normal tension glaucoma (NTG), 110 with POAG, and 28 with the secondary glaucomaCondition assessment and treatment plans were presented for 390 glaucoma cases receiving no treatment. Adjustment was made in the medical treatment of 138 eyes. Following glaucoma iltration surgery, 52 eyes received clinical advice on subsequent treatment.

Conclusion: The simplified 24-hour IOP monitoring method is readily accepted by patients, which is of great significance for providing guidance on the diagnosis of glaucoma and the assessment of the efficacy of glaucoma surgery. However, one-time 24-hour IOP monitoring is not sufficiently efficacious to make a definite diagnosis of NTG. Therefore,long-term follow-up and repeated 24-hour IOP monitoring are required to diagnose NTG, along with a variety of related examinations. (Eye Science 2013;28:119-123)

Purpose: To analyze the sensitivity and specificity of X-ray, B-ultrasound, and CT scan in diagnosing ocular foreign bodies and to compare the accuracy of applying these three imaging tools in locating ocular foreign bodies.

Methods:A retrospective review was conducted of radiographic and clinical eye examination data from 62 patients (66 eyes) who were suspected with ocular foreign bodies at first presentation to zhongshan ophthalmic Center between August 2007 and october 2011. The sensitivity and specificity of X- ray, B-ultrasound and CT scan in the diagnosis of ocular foreign bodies were investigated and their accuracy in locating ocular foreign bodies was compared.

Results:A total of 75.8% of subjects had ocular foreign bodies; 66% of these were metal materials. The patients with intraocular, eyeball wall, and extraocular foreign bodies accounted for 46, 28, and 26%, respectively. The sensitivity of applying X-ray, CT scan, and B-ultrasound in the diagnosis of ocular foreign bodies was 58.3, 61.7, and 75%, the specificity was 63.3, 100, and 87.5%, and the accuracy of locating foreign bodies was 73.4, 94.7, and 86.5%, respectively. The properties of foreign bodies affected the diagnosis of X-ray, but exerted little impact upon B-ultrasound and CT scan.

Conclusion: A fairly high incidence of ocular foreign bodies was noted in patients suspected with ocular foreign bodies at their first presentations. X-ray combined with CT scan or X-ray in combination with B ultrasound showed a relatively high sensitivity and specificity in diagnosing ocular foreign bodies. The CT scan had the highest accuracy in locating ocular foreign bodies.

Purpose: To analyze the sensitivity and specificity of X-ray, B-ultrasound, and CT scan in diagnosing ocular foreign bodies and to compare the accuracy of applying these three imaging tools in locating ocular foreign bodies.

Methods:A retrospective review was conducted of radiographic and clinical eye examination data from 62 patients (66 eyes) who were suspected with ocular foreign bodies at first presentation to zhongshan ophthalmic Center between August 2007 and october 2011. The sensitivity and specificity of X- ray, B-ultrasound and CT scan in the diagnosis of ocular foreign bodies were investigated and their accuracy in locating ocular foreign bodies was compared.

Results:A total of 75.8% of subjects had ocular foreign bodies; 66% of these were metal materials. The patients with intraocular, eyeball wall, and extraocular foreign bodies accounted for 46, 28, and 26%, respectively. The sensitivity of applying X-ray, CT scan, and B-ultrasound in the diagnosis of ocular foreign bodies was 58.3, 61.7, and 75%, the specificity was 63.3, 100, and 87.5%, and the accuracy of locating foreign bodies was 73.4, 94.7, and 86.5%, respectively. The properties of foreign bodies affected the diagnosis of X-ray, but exerted little impact upon B-ultrasound and CT scan.

Conclusion: A fairly high incidence of ocular foreign bodies was noted in patients suspected with ocular foreign bodies at their first presentations. X-ray combined with CT scan or X-ray in combination with B ultrasound showed a relatively high sensitivity and specificity in diagnosing ocular foreign bodies. The CT scan had the highest accuracy in locating ocular foreign bodies.

Purpose: To evaluate visual outcomes after implantation of an aspheric multifocal/intraocular lens (MIOL) or an aspheric monofocal intraocular lens (IOL).
Methods: This was a prospective nonrandomized study. During 3-months of post-operative follow-up, the following outcomes for SN6AD1 MIOL (multifocal group) and SN60WF IOL (monofocal group)were compared:uncorrected (UDVA) and corrected (CDVA) distance visual acuity, uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuity, Chinese character near visual acuity, uncorrected intermediate visual acuity (UIVA) under high (100%contrast) and low contrast (10%contrast), UIVA for different IOL powers, and a quality-of-life questionnaire.
Results: UNVA, DCNVA, and UIVA under high contrast in the multifocal group were significantly better than those in the monofocal group(P <0.05). UDVA, CDVA and UIVA under low contrast did not differ between groups at 63 cm and 100 cm (P >0.05). In most cases, Chinese character near visual acuity was significantly better in the multifocal group (P <0.05). UNVA and UIVA at 63 cm improved over time during 3 months post-operatively. Better UIVA was found in emmetropic and mild myopic eyes as compared to hyperopic ones. The patients in the multifocal group had a higher degree of satisfaction and performed better on near and intermediate tasks, although with greater complaints of visual disturbance.
Conclusion: The SN6AD1 MIOL provides significantly better UNVA, DCNVA and UIVA under high contrast conditions, and better Chinese character near visual acuity. Patients receiving the SN6AD1 MIOL reported a better quality of vision in spite of more serious visual disturbances. Better UIVA was observed in emmetropic and mildly myopic eyes. (Eye Science 2012; 27: 5-12).

Purpose: To evaluate visual outcomes after implantation of an aspheric multifocal/intraocular lens (MIOL) or an aspheric monofocal intraocular lens (IOL).
Methods: This was a prospective nonrandomized study. During 3-months of post-operative follow-up, the following outcomes for SN6AD1 MIOL (multifocal group) and SN60WF IOL (monofocal group)were compared:uncorrected (UDVA) and corrected (CDVA) distance visual acuity, uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuity, Chinese character near visual acuity, uncorrected intermediate visual acuity (UIVA) under high (100%contrast) and low contrast (10%contrast), UIVA for different IOL powers, and a quality-of-life questionnaire.
Results: UNVA, DCNVA, and UIVA under high contrast in the multifocal group were significantly better than those in the monofocal group(P <0.05). UDVA, CDVA and UIVA under low contrast did not differ between groups at 63 cm and 100 cm (P >0.05). In most cases, Chinese character near visual acuity was significantly better in the multifocal group (P <0.05). UNVA and UIVA at 63 cm improved over time during 3 months post-operatively. Better UIVA was found in emmetropic and mild myopic eyes as compared to hyperopic ones. The patients in the multifocal group had a higher degree of satisfaction and performed better on near and intermediate tasks, although with greater complaints of visual disturbance.
Conclusion: The SN6AD1 MIOL provides significantly better UNVA, DCNVA and UIVA under high contrast conditions, and better Chinese character near visual acuity. Patients receiving the SN6AD1 MIOL reported a better quality of vision in spite of more serious visual disturbances. Better UIVA was observed in emmetropic and mildly myopic eyes. (Eye Science 2012; 27: 5-12).

Purpose: To evaluate the diagnostic performance of the photopic negative response (PhNR) for the detection of primary open-angle glaucoma (POAG).

Methods: Fifty-two normal subjects (52 eyes) and 173 POAG patients (173 eyes) were studied. The PhNR was elicited using a white stimuli on a white background. The mean deviation (MD) and pattern standard deviation (PSD) of the visual field were measured using standard automated  perimetry (SAP). Spectral  domain  optical  coherence  tomography (SDOCT) was used to measure the mean thickness of the retinal nerve fiber layer (RNFL).

Results: In the glaucoma group, as compared to the normal group, the amplitudes of a-waves, b-waves and PhNR were significantly smaller (P<0.001), and the PhNR implicit time was significantly longer (P=0.004). The MD, PSD and mean thickness of the RNFL were  significantly correlated with the amplitude of the PhNR (P<0.001). The area under the receiver operating characteristic curve (AUCs) for the amplitudes of a-waves, b-waves and PhNR were 0.853, 0.830 and 0.918, respectively. when the specificity was ≥95%, the sensitivities were 60.4%, 54.2% and 85.4% respectively.
Conclusion: The PhNR amplitude was reduced even when the loss in visual field sensitivity was mild, which suggests that PhNR might be a useful indicator of early glaucoma disease. (Eye science 2012 ; 27:113一118)

Keywords: electroretinography; primary open-angle glaucoma; photopic negative response

Purpose: To evaluate the diagnostic performance of the photopic negative response  (PhNR)  for  the  detection of primary open-angle glaucoma (POAG).

Methods: Fifty-two normal subjects (52 eyes) and 173 POAG patients (173 eyes) were studied. The PhNR was elicited using a white stimuli on a white background. The mean deviation (MD) and pattern standard deviation (PSD) of the visual field were measured using standard automated  perimetry (SAP). Spectral  domain  optical  coherence  tomography (SDOCT) was used to measure the mean thickness of the retinal nerve fiber layer (RNFL).

Results: In the glaucoma group, as compared to the normal group, the amplitudes of a-waves, b-waves and PhNR were significantly smaller (P<0.001), and the PhNR implicit time was significantly longer (P=0.004). The MD, PSD and mean thickness of the RNFL were  significantly correlated with the amplitude of the PhNR (P<0.001). The area under the receiver operating characteristic curve (AUCs) for the amplitudes of a-waves, b-waves and PhNR were 0.853, 0.830 and 0.918, respectively. when the specificity was ≥95%, the sensitivities were 60.4%, 54.2% and 85.4% respectively.
Conclusion: The PhNR amplitude was reduced even when the loss in visual field sensitivity was mild, which suggests that PhNR might be a useful indicator of early glaucoma disease. (Eye science 2012 ; 27:113一118)

Keywords: electroretinography; primary open-angle glaucoma; photopic negative response

Purpose: To describe the magnetic resonance imaging (MRI) features of orbital rhabdomyosarcoma (RMS).

Methods:Thirty-nine patients with histopathologically confirmed orbital RMS were retrospectively reviewed. All patients underwent orbital conventional MRI, including axial, sagittal, and coronal T1-weighted, T2-weighted, and postcontrast T1-weighted sequences. The location, shape, margin, and MRI signal of the 39 lesions were reviewed. DWI in 15 patients and susceptibility weighted imaging (SWI) in 2 patients were also analyzed.

Results: Orbital MRI was available in 39 patients and revealed a soft tissue mass in the orbital region in all cases. Of the 39 patients, the primary tumor sites were limited to the orbital proper in 31 cases, while 28 cases had extraocular muscle invasion and 8 cases had extraorbital invasion. All lesions were unilateral. Thirty-three cases were well-defined soft tissue masses and 6 cases appeared as less well-defined soft-tissue masses. Thirty-four cases showed homogeneous isointense or slightly hypointense signals on T1-weighted imaging (T1WI) and hyperintense signal on T2-weighted imaging (T2WI) compared with extraocular muscles.  Five cases had heterogeneous signals with focal areas of increased signal on T1WI or decreased signal on T2WI, including l case with hypointense signal on SWI. The mean apparent diffusion coefficient (ADC) value of the viable part of tumors was (0.925±0.09)×10^-3mm²/s. All cases showed moderate to marked enhancement after contrast administration.

Conclusion:Several MRI features-including homogeneous isointense or slightly hypointense signal on T1WI and slightly hyperintense signal on T2WI, relative low ADC values, and moderate to marked enhancement, extraocular muscles invasion,  and extraorbital extensionare helpful in the diagnosis of orbital RMS.

Purpose: To describe the magnetic resonance imaging (MRI) features of orbital rhabdomyosarcoma (RMS).

Methods:Thirty-nine patients with histopathologically confirmed orbital RMS were retrospectively reviewed. All patients underwent orbital conventional MRI, including axial, sagittal, and coronal T1-weighted, T2-weighted, and postcontrast T1-weighted sequences. The location, shape, margin, and MRI signal of the 39 lesions were reviewed. DWI in 15 patients and susceptibility weighted imaging (SWI) in 2 patients were also analyzed.

Results: Orbital MRI was available in 39 patients and revealed a soft tissue mass in the orbital region in all cases. Of the 39 patients, the primary tumor sites were limited to the orbital proper in 31 cases, while 28 cases had extraocular muscle invasion and 8 cases had extraorbital invasion. All lesions were unilateral. Thirty-three cases were well-defined soft tissue masses and 6 cases appeared as less well-defined soft-tissue masses. Thirty-four cases showed homogeneous isointense or slightly hypointense signals on T1-weighted imaging (T1WI)  and hyperintense signal on T2-weighted imaging (T2WI) compared with extraocular muscles.  Five cases had heterogeneous signals with focal areas of increased signal on T1WI or decreased signal on T2WI, including 1 case with hypointense signal on SWI. The mean apparent diffusion coefficient (ADC) value of the viable part of tumors was (0.925±0.09)×10^-3mm²/s. All cases showed moderate to marked enhancement after contrast administration.

Conclusion:Several MRI features-including homogeneous isointense or slightly hypointense signal on T1WI and slightly hyperintense signal on T2WI, relative low ADC values, and moderate to marked enhancement, extraocular muscles invasion,  and extraorbital extensionare helpful in the diagnosis of orbital RMS.

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 misdiagnosed as having bilateral squint or amblyopia for years, with best corrected visual acuity less than 0.1. 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 detachment involved the macular area, and macular hole was detected in the abnormal expansion excavation of optic disc. The epiretinal membrane and subretinal membrane were completely peeled during the surgery. Combined photocoagulation in abnormal expansion excavation of optic disc and silicone oil tamponade were also performed.
Results: All eyes achieved anatomical resolution. 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 0.01 to 0.2 at the final follow-up, no retinal detachment recurred, and no silicone oil fluid flowed into the subretinal space. The silicone oil was successfully removed postoperatively after 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.

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 misdiagnosed as having bilateral squint or amblyopia for years, with best corrected visual acuity less than 0.1. 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 detachment involved the macular area, and macular hole was detected in the abnormal expansion excavation of optic disc. The epiretinal membrane and subretinal membrane were completely peeled during the surgery. Combined photocoagulation in abnormal expansion excavation of optic disc and silicone oil tamponade were also performed.
Results: All eyes achieved anatomical resolution. 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 0.01 to 0.2 at the final follow-up, no retinal detachment recurred, and no silicone oil fluid flowed into the subretinal space. The silicone oil was successfully removed postoperatively after 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.