Intraoperative OCT-assisted relaxing retinotomies in the management of coloboma-associated retinal detachment

PURPOSE: To evaluate the role of intraoperative optical coherence tomography (iOCT) in performing relaxing retinotomies in coloboma related-retinal detachment. METHODS: The patient presents with decreased vision in the right eye (RE) for 1 year, with Snellen's best-corrected visual acuity (BCVA) of 20/100. RE Type 5 Ida-Mann Retinochoroidal coloboma with rhegmatogenous Retinal detachment (RRD). Retinal detachment was treated with 25-gauge pars plana vitrectomy. Subretinal fluid was drained through the intercalary membrane (ICM) break. The microscope-integrated OCT system identified taut ICM after fluid-air exchange. Repeat iOCT was done to check for the adequacy of the retinotomy by looking for flattening of the retina. The step was repeated till the retina was noted to be flat. Circumferential endolaser photocoagulation was done along the entire margin of the coloboma, followed by 5000 centistoke silicone oil injection. RESULTS: The retina remained attached under oil with the BCVA improved to 20/50 at 6-month follow-up. Conclusion:Intraoperative OCT can assist in deciding the extent of relaxing retinotomy in coloboma-associated retinal detachment with taut ICM.