Daufenbach D R, Ruttum M S, Pulido J S, Keech R V
Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, USA.
Ophthalmology. 1998 Aug;105(8):1455-8. doi: 10.1016/S0161-6420(98)98028-9.
The purpose of the study was to determine the prevalence of retinal detachment and associated anomalies in pediatric patients with chorioretinal colobomas.
Observational case series.
Forty-eight patients (86 eyes) of patients with chorioretinal colobomas followed in two academic pediatric eye clinics were reviewed.
The frequency of associated systemic abnormalities and the prevalence of retinal or choroidal detachment during the follow-up period.
Forty-eight patients (86 eyes) were identified; ocular involvement ranged from small colobomas with isolated chorioretinal involvement to large colobomas affecting the iris, choroid, retina, and optic nerve. The mean ages at initial and most recent examinations were 27 and 100 months, respectively. Follow-up averaged 6 years, 1 month. Six retinal detachments were found in four patients. Patient ages at the time of detection of retinal detachment were 5 months, 29 months, 10 years, and 15 years. A choroidal detachment was found in a child at age 9 years. The combined prevalence of retinal or choroidal detachment was 10.4% of patients and 8.1% of affected eyes. Thirteen eyes were microphthalmic, and six had microcornea. Eighteen patients (38%) had other systemic abnormalities.
The 8.1% prevalence of retinal or choroidal detachment among eyes in our series was much smaller than previously cited estimates of 23% to 43%. The higher figures probably reflect a referral bias toward patients with vitreoretinal problems and an older patient population. Because of the acknowledged difficulty of managing retinal detachments in patients with chorioretinal colobomas, emphasis should be directed toward early detection and possible prophylactic therapy. The high proportion of patients who have associated systemic abnormalities indicates the need for thorough evaluation of these children by other pediatric specialists.
本研究的目的是确定患有脉络膜视网膜缺损的儿科患者视网膜脱离及相关异常的患病率。
观察性病例系列。
对在两家学术性儿科眼科诊所随访的48例患有脉络膜视网膜缺损的患者（86只眼）进行了回顾。
随访期间相关全身异常的频率以及视网膜或脉络膜脱离的患病率。
共确定48例患者（86只眼）；眼部受累范围从小的仅累及脉络膜视网膜的缺损到大的累及虹膜、脉络膜、视网膜和视神经的缺损。初次检查和最近一次检查的平均年龄分别为27个月和100个月。平均随访6年1个月。在4例患者中发现6例视网膜脱离。视网膜脱离检测时患者的年龄分别为5个月、29个月、10岁和15岁。在一名9岁儿童中发现脉络膜脱离。视网膜或脉络膜脱离的合并患病率在患者中为10.4%，在受累眼中为8.1%。13只眼为小眼球，6只眼有小角膜。18例患者（38%）有其他全身异常。
我们系列研究中眼中视网膜或脉络膜脱离的患病率为8.1%，远低于先前引用的23%至43%的估计值。较高的数字可能反映了对玻璃体视网膜问题患者和老年患者群体的转诊偏倚。由于公认脉络膜视网膜缺损患者视网膜脱离的管理困难，应着重于早期检测和可能的预防性治疗。有相关全身异常的患者比例较高，表明其他儿科专家需要对这些儿童进行全面评估。
