ObjectiveTo investigate the successful signs of laser photocoagulation or endolaser combined vitrectomy for congenital optic disc pit (ODP) with serous macular detachment.MethodsA retrospective case analysis. Twelve eyes of 12 patients with congenital ODP complicated with serous macular detachment diagnosed in Zhongshan Ophthalmic Center from 2003 to 2018 were included in this study. There were 2 males (2 eyes) and 8 females (8 eyes). The average age was 30.17 years old. Retinal laser photocoagulation and/or vitrectomy were performed in all the eyes. The optic disc and macular area were scanned using the tracking mode of the Germany Heidelberg Spectralis OCT instrument. The " dam-sign” change was a retinal choroidal scar on the channel between the ODP and the macula on the OCT image after treatment. The eyes were divided into a " dam-sign” change group (group A, 10 eyes) and no " dam-sign” change group (group B, 2 eyes). The BCVA of eyes in group A was 0.03-0.6. In group A, 1 eye was treated with laser photocoagulation alone, 9 eyes were treated with vitrectomy combined with laser photocoagulation. The BCVA of eyes in group B was 0.1. All the eyes in group B underwent vitrectomy combined with laser photocoagulation. The follow-up was ranged from 6 to 174 months. The same equipment and method before treatment were used for 1, 3, 6, 12, 18, and 24 months after treatment. The BCVA, absorption of subretinal fluid (SRF) and the formation of " dam-sign” change were observed.ResultsAt the last follow-up, the BCVA of eyes in group A was 0.4-1.0 (0.4 in 1 eye, 0.5 in 3 eyes, 0.6 in 2 eyes, 0.8 in 3 eyes, 1.0 in 1 eye). In 9 eyes treated with vitrectomy combined with laser photocoagulation, SRF was completely absorbed. In 1 eye treated with laser photocoagulation alone, SRF remained in small amount. The BCVA of the two eyes in group B was 0.03 and 0.3, respectively; and SRF was not absorbed in both of them.ConclusionsThe " dam-sign” change near optic disc after laser photocoagulation can promote SRF absorption and improve BCVA. It can be used as a success indicator after treatment.
ObjectiveTo observe and analyze the clinical features, treatment methods and efficacy of patients with retinopathy associated with incontinentia pigmenti (IP).MethodsA retrospective case study. Twelve clinical confirmed IP patients (24 eyes) in Zhongshan Ophthalmic Center of Sun Yat-sen University from January 2015 to December 2018 were included in this study. The best corrected visual acuity and intraocular pressure examination were performed in patients (＞4 years old). All patients were examined on the anterior segment, vitreous body, and fundus under topical anesthesia or general anesthesia. Eight cases underwent genetic testing. Patients with active disease should be given anti-vascular endothelial growth factor (VEGF) drug treatment, retinal laser photocoagulation or vitrectomy, those without active disease should be observed. All patients were followed up for 1 to 3 months, with an average follow-up time of 18.7 months.ResultsAll patients were all female, with an average age of 6.3±9.8 years old at the first ophthalmology visit. According to the recommendations of the pediatrician, 3 cases were actively screened for ophthalmology (referrals), with an average age of 0.4±0.5 years (median age: 2 months). A total of 9 cases were not recommended for referrals (non-referrals), including 3 cases of ophthalmology who were diagnosed for the first time due to visual impairment, and 6 cases of undiagnosed IP before the ophthalmology visit, the average age of their first visit was 8.2±10.8 years (medium age: 3 years old). The age of the first visit for non-referred patients was larger than that of referrals, and the difference was statistically significant (Z=−2.141, P=0.036). Among the 24 eyes of 12 cases, there were no obvious fundus abnormalities in 1 case or 2 eyes, 11 cases of IP-related retinopathy in 22 eyes (91.7%, 22/24), 8 cases of binocular asymmetry (66.7%, 8/12). There were active lesions on the fundus in 7 eyes (29.2%, 7/24). Patients underwent simple retinal laser photocoagulation and/or anti-VEGF drug therapy. During the follow-up, retinal neovascularization recurred in 1 eye. Among the 8 cases that underwent genetic testing, 3 cases (37.5%, 3/8) were deleted in exons 4-10 of the IKBKG gene.ConclusionsIP is more common in women. IP-associated retinopathy is noted with early-onset, asymmetrical retinopathy, which is identified with retinal neovascularization and vitreous proliferation. Early detection and timely treatment are essential.