1. Surgical outcomes of progressive tractional retinal detachment associated with familial exudative vitreoretinopathy
- Author
-
Yuri Nakayama, Sachiko Nishina, Takahiro Yamane, Tadashi Yokoi, and Noriyuki Azuma
- Subjects
Male ,medicine.medical_specialty ,Visual acuity ,genetic structures ,Adolescent ,Fundus Oculi ,medicine.medical_treatment ,Familial Exudative Vitreoretinopathies ,Visual Acuity ,Vitrectomy ,Retina ,Neovascularization ,chemistry.chemical_compound ,Retinal Diseases ,Ophthalmology ,medicine ,Humans ,Fluorescein Angiography ,Child ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Infant, Newborn ,Retinal Detachment ,Retinal detachment ,Infant ,Retinal ,Eye Diseases, Hereditary ,medicine.disease ,Fluorescein angiography ,eye diseases ,Surgery ,Scleral Buckling ,Treatment Outcome ,chemistry ,Child, Preschool ,Familial exudative vitreoretinopathy ,Female ,sense organs ,medicine.symptom ,business ,Scleral buckling ,Follow-Up Studies - Abstract
Purpose To evaluate various surgeries for treating retinal detachment (RD) associated with familial exudative vitreoretinopathy (FEVR). Design Retrospective, interventional case series. Methods The charts of 22 patients who underwent surgery were reviewed. A complete ophthalmic examination was performed including wide-field fundus images with fluorescein angiography. The primary and secondary outcomes were fundus features (vascular activity of the fibrovascular proliferation and extent of tractional RD) and visual acuity (VA), respectively. Results Thirty-one eyes were included (12 eyes underwent scleral buckling, 1 scleral buckling and vitrectomy, 7 vitrectomy alone, and 11 lensectomy and vitrectomy). Twenty-six eyes were reattached during 1 surgery. Scleral buckling resulted in cessation of fibrovascular proliferation and retinal reattachment; only 1 of these eyes required vitrectomy. Lens-sparing vitrectomy resulted in stabilized fibrovascular proliferation and retinal reattachment. Vitrectomy with lensectomy did not achieve retinal reattachment in 4 eyes. Fibrovascular proliferation has a rich vascular component in patients younger than 3 years, and collagen fibers were present mainly with more advanced age. The postoperative VA improved in 5 of 8 eyes examined, was unchanged in 1 eye, and decreased in 2 eyes with macular involvement. Conclusions FEVR-induced RDs are highly variable and require careful preoperative evaluation to determine the best surgical procedure. Vitrectomy with release of posterior traction is essential in younger patients with vascularly active fibrovascular proliferation, whereas scleral buckling may be important for cases with peripheral traction anterior to the equator. In all cases, peripheral thermal treatment applied to all ischemic areas contributed to reduced peripheral neovascularization.
- Published
- 2014