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Lingam G, Sen AC, Lingam V, Bhende M, Padhi TR, Xinyi S. Ocular coloboma-a comprehensive review for the clinician. Eye (Lond) 2021; 35:2086-2109. [PMID: 33746210 PMCID: PMC8302742 DOI: 10.1038/s41433-021-01501-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 02/09/2021] [Accepted: 03/01/2021] [Indexed: 12/12/2022] Open
Abstract
Typical ocular coloboma is caused by defective closure of the embryonal fissure. The occurrence of coloboma can be sporadic, hereditary (known or unknown gene defects) or associated with chromosomal abnormalities. Ocular colobomata are more often associated with systemic abnormalities when caused by chromosomal abnormalities. The ocular manifestations vary widely. At one extreme, the eye is hardly recognisable and non-functional—having been compressed by an orbital cyst, while at the other, one finds minimalistic involvement that hardly affects the structure and function of the eye. In the fundus, the variability involves the size of the coloboma (anteroposterior and transverse extent) and the involvement of the optic disc and fovea. The visual acuity is affected when coloboma involves disc and fovea, or is complicated by occurrence of retinal detachment, choroidal neovascular membrane, cataract, amblyopia due to uncorrected refractive errors, etc. While the basic birth anomaly cannot be corrected, most of the complications listed above are correctable to a great extent. Current day surgical management of coloboma-related retinal detachments has evolved to yield consistently good results. Cataract surgery in these eyes can pose a challenge due to a combination of microphthalmos and relatively hard lenses, resulting in increased risk of intra-operative complications. Prophylactic laser retinopexy to the border of choroidal coloboma appears to be an attractive option for reducing risk of coloboma-related retinal detachment. However, a majority of the eyes have the optic disc within the choroidal coloboma, thus making it difficult to safely administer a complete treatment.
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Affiliation(s)
- Gopal Lingam
- National University Hospital, Singapore, Singapore. .,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. .,Singapore Eye Research Institute (SERI), Singapore, Singapore.
| | - Alok C Sen
- Sadguru Netra Chikitsalaya, Chitrakoot, India
| | | | | | | | - Su Xinyi
- National University Hospital, Singapore, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Singapore Eye Research Institute (SERI), Singapore, Singapore.,Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
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3
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Hou X, Guo Y, Liu J, Li S, Fan W, Lin M, Rokohl AC, Heindl LM. A Systematic Review of the Clinical Manifestations and Diagnostic Methods for Macular Coloboma. Curr Eye Res 2021; 46:913-918. [PMID: 33478254 DOI: 10.1080/02713683.2020.1853779] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objectives: To present the clinical features of and diagnostic methods used for macular coloboma (MC), and to analyze the factors associated with best-corrected visual acuity (BCVA) in patients with MC.Methods: A systematic review using the MEDLINE (PubMed), EMBASE, LILACS, and Cochrane databases was performed. The factors associated with BCVA were analyzed.Results: A total of 21 patients (mean age at diagnosis, 18.1 ± 14.6 years) with 36 eyes affected by MC (5 unilateral, 16 bilateral) were included in the study. All 21 patients (100%) had undergone a good-quality fundus examination. The size of the MC lesions ranged from 1.0 × 1.2 to 4.0 × 4.0 disc diameters (DD). Twenty-seven (73%) eyes had pigmented MC, seven (19%) had non-pigmented MC, and one (3%) had an unspecific type. The diagnosis was confirmed using spectral-domain optical coherence tomography (SD-OCT) in 16 (43.2%) eyes. A positive correlation was found between BCVA and the type of MC (β = 0.876, p = .006) and abnormal eye movement (β = 0.087, p = .018), and a negative correlation was found between BCVA and a contributory medical history of ventricular septal defect (β = -0.327, p = .001).Conclusions: Pigmented MC was the most common type and had the highest possibility of causing impaired vision in the affected eyes. Additionally, joint examinations should be applied for diagnostic confirmation of MC. Furthermore, fundoscopy, electroretinogram, electrooculography, fundus fluorescein angiography, and SD-OCT are all critical for differential diagnosis of MC-like lesions.
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Affiliation(s)
- Xiaoyi Hou
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Yongwei Guo
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jinhua Liu
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Senmao Li
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Wanlin Fan
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ming Lin
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Alexander C Rokohl
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ludwig M Heindl
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Center for Integrated Oncology (CIO) Aachen-Bonn-Cologne-Duesseldorf, Cologne, Germany
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4
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Chakrabarti R, Campbell TG, Carden SM. Chorioretinal colobomas in neonatal intensive care using ocular coherence tomography. Clin Exp Optom 2020; 104:119-121. [PMID: 32307735 DOI: 10.1111/cxo.13074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Rahul Chakrabarti
- Department of Ophthalmology, The Royal Children's Hospital , Melbourne, Australia.,Department of Neuro-Ophthalmology, The Royal Victorian Eye and Ear Hospital , Melbourne, Australia
| | - Thomas G Campbell
- Department of Ophthalmology, The Royal Children's Hospital , Melbourne, Australia.,Department of Neuro-Ophthalmology, The Royal Victorian Eye and Ear Hospital , Melbourne, Australia
| | - Susan M Carden
- Department of Ophthalmology, The Royal Children's Hospital , Melbourne, Australia.,Department of Neuro-Ophthalmology, The Royal Victorian Eye and Ear Hospital , Melbourne, Australia.,Department of Paediatrics, The University of Melbourne , Melbourne, Australia
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Kumar V, Kumawat D, Mahalingam K. Macular Colobomata: Comparison of Clinical and Optical Coherence Tomography Features With Serologic Results. Am J Ophthalmol 2019; 200:47-56. [PMID: 30633892 DOI: 10.1016/j.ajo.2018.12.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 12/27/2018] [Accepted: 12/29/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE To assess the correlation between the morphologic features and serology in eyes with macular colobomata (MC). DESIGN Retrospective comparative case series. METHODS Setting: Institutional. STUDY POPULATION Patients presenting with MC to the retina clinic over a period of 2 years (January 2016 to December 2017). Interventional/Observational Procedure: Color fundus and swept-source optical coherence tomography (SSOCT) features were reviewed and assessed in 3 groups based on the serum IgG results: positive for Toxoplasma, positive for cytomegalovirus (CMV), and serology negative. MAIN OUTCOME MEASURE Morphologic features on clinical and OCT-based examination. RESULTS A total of 49 eyes of 27 patients were recruited. The mean age was 24.8 ± 14.9 years (range 7-60 years). While the lesion size, the presence of satellite lesions, choroidal excavation, and choroidal lacunae (large choroidal vessels) on SSOCT differed significantly among the groups, pigmentation, retinal fibrosis, shape, retinal vessel pattern, and choroidal vessel visibility did not vary significantly. The lesions in CMV serology-positive cases were mostly solitary (n = 8/8), large (n = 5/8) and deeply excavated (n = 8/8). The lesions in Toxoplasma serology-positive cases were mostly flat to shallow (n = 18/26), medium-sized (n = 19/26), and either a solitary lesion (n = 17/26) or multiple satellite lesions (n = 9/26). The lesions in serology-negative cases were mostly small to medium (n = 13/15), solitary (n = 15/15), deeply excavated lesions (n = 11/15) with choroidal lacunae (n = 8/15). CONCLUSIONS The clinical and SSOCT features such as the lesion size, the presence of satellite lesions, choroidal excavation, and choroidal lacunae can provide a clue toward the etiology of macular colobomata.
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Affiliation(s)
- Vinod Kumar
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Devesh Kumawat
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
| | - Karthikeyan Mahalingam
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Previato M, Frederico FB, Murata FHA, Siqueira RC, Barbosa AP, Silveira-Carvalho AP, Meira CDS, Pereira-Chioccola VL, Gava R, Martins Neto PP, de Mattos LC, de Mattos CCB. A Brazilian report using serological and molecular diagnosis to monitoring acute ocular toxoplasmosis. BMC Res Notes 2015; 8:746. [PMID: 26643197 PMCID: PMC4671220 DOI: 10.1186/s13104-015-1650-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 10/29/2015] [Indexed: 12/04/2022] Open
Abstract
Background Toxoplasmosis was recently included as a neglected disease by the Center for Disease Control. Ocular toxoplasmosis is one clinical presentation of congenital or acquired infection. The laboratory diagnosis is being used worldwide to support the clinical diagnosis and imaging. The aim of this study was to evaluate the use of serology and molecular methods to monitor acute OT in immunocompetent patients during treatment. Methods Five immunocompetent patients were clinically diagnosed with acute OT. The clinical evaluation was performed by ophthalmologic examination using the Early Treatment Diabetic Retinopathy Study, best-corrected visual acuity, slit lamp biomicroscopy, fundoscopic examination with indirect binocular ophthalmoscopy color fundus photography, fluorescein angiography and spectral optical coherence tomography (OCT). Serology were performed by ELISA (IgA, IgM, IgG) and confirmed by ELFA (IgG, IgM). Molecular diagnoses were performed in peripheral blood by cPCR using the Toxoplasma gondiiB1 gene as the marker. Follow-up exams were performed on day +15 and day +45. Results Only five non-immunocompromised male patients completed the follow up and their data were used for analysis. The mean age was 41.2 ± 11.3 years (median: 35; range 31–54 years). All of them were positive for IgG antibodies but with different profiles for IgM and IgA, as well as PCR. For all patients the OCT exam showed active lesions with the inner retinal layers being abnormally hyper-reflective with full-thickness disorganization of the retinal reflective layers, which assumed a blurred reflective appearance and the retina was thickened. Conclusions The presence of IgA and IgM confirmed the acute infection and thus was in agreement with the clinical evaluation. Our results show the adopted treatment modified the serological profile of IgM antibodies and the PCR results, but not the IgG and IgA antibodies and that imaging is a good tool to follow-up patients. Electronic supplementary material The online version of this article (doi:10.1186/s13104-015-1650-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mariana Previato
- Immunogenetics Laboratory, Department of Molecular Biology, Faculdade de Medicina de São José do Rio Preto-FAMERP, Avenida Brigadeiro Faria Lima, 5416, São José do Rio Preto, Sao Paulo state, 15090-000, Brazil. .,FAMERP Toxoplasma Research Group, Avenida Brigadeiro Faria Lima, 5416, São José do Rio Preto, Sao Paulo state, 15090-000, Brazil.
| | - Fábio Batista Frederico
- Retinopathy Outpatient Clinic, Hospital de Base da Fundação Faculdade Regional de Medicina-HB-FUNFARME, Avenida Brigadeiro Faria Lima, 5544, São José do Rio Preto, Sao Paulo state, 15090-000, Brazil. .,FAMERP Toxoplasma Research Group, Avenida Brigadeiro Faria Lima, 5416, São José do Rio Preto, Sao Paulo state, 15090-000, Brazil.
| | - Fernando Henrique Antunes Murata
- Immunogenetics Laboratory, Department of Molecular Biology, Faculdade de Medicina de São José do Rio Preto-FAMERP, Avenida Brigadeiro Faria Lima, 5416, São José do Rio Preto, Sao Paulo state, 15090-000, Brazil. .,FAMERP Toxoplasma Research Group, Avenida Brigadeiro Faria Lima, 5416, São José do Rio Preto, Sao Paulo state, 15090-000, Brazil.
| | - Rubens Camargo Siqueira
- Immunogenetics Laboratory, Department of Molecular Biology, Faculdade de Medicina de São José do Rio Preto-FAMERP, Avenida Brigadeiro Faria Lima, 5416, São José do Rio Preto, Sao Paulo state, 15090-000, Brazil.
| | - Amanda Pires Barbosa
- Retinopathy Outpatient Clinic, Hospital de Base da Fundação Faculdade Regional de Medicina-HB-FUNFARME, Avenida Brigadeiro Faria Lima, 5544, São José do Rio Preto, Sao Paulo state, 15090-000, Brazil. .,FAMERP Toxoplasma Research Group, Avenida Brigadeiro Faria Lima, 5416, São José do Rio Preto, Sao Paulo state, 15090-000, Brazil.
| | - Aparecida Perpétuo Silveira-Carvalho
- Immunogenetics Laboratory, Department of Molecular Biology, Faculdade de Medicina de São José do Rio Preto-FAMERP, Avenida Brigadeiro Faria Lima, 5416, São José do Rio Preto, Sao Paulo state, 15090-000, Brazil.
| | - Cristina da Silva Meira
- Laboratory of Molecular Biology, of Parasites and Fungi, Instituto Adolfo Lutz-IAL, Aenida Dr Arnaldo,355, São Paulo, São Paulo state, 01246-000, Brazil. .,IAL Toxoplasma Research Group, Instituto Adolfo Lutz, Avenida Dr Arnaldo, 355, São Paulo, Sao Paulo state, 01246-000, Brazil.
| | - Vera Lúcia Pereira-Chioccola
- Laboratory of Molecular Biology, of Parasites and Fungi, Instituto Adolfo Lutz-IAL, Aenida Dr Arnaldo,355, São Paulo, São Paulo state, 01246-000, Brazil. .,IAL Toxoplasma Research Group, Instituto Adolfo Lutz, Avenida Dr Arnaldo, 355, São Paulo, Sao Paulo state, 01246-000, Brazil.
| | - Ricardo Gava
- Laboratory of Molecular Biology, of Parasites and Fungi, Instituto Adolfo Lutz-IAL, Aenida Dr Arnaldo,355, São Paulo, São Paulo state, 01246-000, Brazil. .,IAL Toxoplasma Research Group, Instituto Adolfo Lutz, Avenida Dr Arnaldo, 355, São Paulo, Sao Paulo state, 01246-000, Brazil.
| | - Plínio Pereira Martins Neto
- Retinopathy Outpatient Clinic, Hospital de Base da Fundação Faculdade Regional de Medicina-HB-FUNFARME, Avenida Brigadeiro Faria Lima, 5544, São José do Rio Preto, Sao Paulo state, 15090-000, Brazil.
| | - Luiz Carlos de Mattos
- Immunogenetics Laboratory, Department of Molecular Biology, Faculdade de Medicina de São José do Rio Preto-FAMERP, Avenida Brigadeiro Faria Lima, 5416, São José do Rio Preto, Sao Paulo state, 15090-000, Brazil. .,FAMERP Toxoplasma Research Group, Avenida Brigadeiro Faria Lima, 5416, São José do Rio Preto, Sao Paulo state, 15090-000, Brazil.
| | - Cinara Cássia Brandão de Mattos
- Immunogenetics Laboratory, Department of Molecular Biology, Faculdade de Medicina de São José do Rio Preto-FAMERP, Avenida Brigadeiro Faria Lima, 5416, São José do Rio Preto, Sao Paulo state, 15090-000, Brazil. .,FAMERP Toxoplasma Research Group, Avenida Brigadeiro Faria Lima, 5416, São José do Rio Preto, Sao Paulo state, 15090-000, Brazil.
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