Retinal detachments associated with choroidal colobomas.

Abstract

To summarize the characteristics of the retinal detachments (RDs) that are associated with choroidal colobomas that occur in pediatric and adult patients. A choroidal coloboma is a rare disorder that results from an incomplete closure of the embryonic optic fissure, and their size can range from small colobomas with isolated chorioretinal involvement to large colobomas affecting the iris, choroid, retina, and optic nerve. A RD is occasionally associated with choroidal colobomas, and histological studies of the area of the choroidal coloboma show an absence of normal choroidal tissue, retinal pigment epithelium (RPE), and retina. Near the margin of the coloboma, the inner retinal layer has a central continuation of the marginal intercalary membrane (ICM) within the coloboma. The outer layer folds back, becomes disorganized, and fuses with the RPE. The inner retina gradually thins and merges with the marginal ICM with a high incidence of tears of the ICM developing along the edge of the coloboma or toward the center. Because of the high association of the causative retinal breaks being located within the colobomatous area, vitrectomy, endolaser photocoagulation around the margin of coloboma, and long-term tamponade with silicone oil or gas are recommended treatments. In addition, the presence of the macula within the area of the laser photocoagulation should be considered. However, the recurrence rate is high and multiple surgeries are required to reattach the detached retina.