Clinical analysis and management of pediatric retinal detachment associated with morning glory syndrome

Objective To analyze and discuss the clinical features and management of pediatric retinal detachment (RD) associated with morning glory syndrome (MGS).Methods The clinical data of 49 patients (51 eyes) with RD associated with MGS were retrospectively analyzed,including 27 males (27 eyes) and 22 females (24 eyes).The age at first diagnosis ranged from 1 week after birth and 13 years old (4.2±3.2) years.There were 33 eyes of exudative RD,3 eyes of rhegmatogenous RD and 15 eyes of RD with undetermined cause.Twenty eyes of 20 patients had other congenital ocular abnormalities,including persistent hyperplastic primary vitreous,microphthalmia,choroidal coloboma,iris coloboma.Besides retinal detachment,other complications were found,including cataract,secondary glaucoma,corneal leukoma or edema,strabismus and nystagmus.Twenty-two cases (22 eyes) received treatment.Five cases of mild exudative retinal detachment took oral methazolamide tablets.Three eyes with mild and restricted retinal detachments got retinal laser photocoagulation around the optic disc.Fourteen cases of 14 eyes underwent surgery including vitrectomy,lensectomy,and phacoemulsification.Follow-up after treatment were three months or more,with an average of (20.3±11.8) months.The visual acuity,retinal reattachment and intraocular pressure and other complications after treatment were followed up.Results Five patients of exudative retinal detachment were remainedstable by taking methazolamide tablets.Two of the 3 eyes remained stable after laser therapy; however,the remaining one eye was not controlled after relaser.Cataract and glaucoma were resolved by lensectomy in 7 eyes and phaco-emulsification surgery in 1 eye.Retina was re-attached in 6 eyes after vitrectomy.Among those treated,10 eyes had records of visual acuity.Visual acuity was improved in 1 eye after laser therapy and remained stable in 9 eyes.There were no drugs and surgery-related complications.Conclusions Retinal detachment was the main complication of MGS.The high incidence and poor prognosis call for the need of close follow-up and timely treatment,including medicine,laser and surgery. Key words: Optic nerve diseases/congenital;  Retinal detachment/therapy;  Laser coagulation;  Vitrectomy