1. Structural Abnormalities of the Inner Macula in Incontinentia Pigmenti
- Author
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Ronald Hobbs, Marielle P. Young, J. Basilius, Timothy C. Michaelis, M. Elizabeth Hartnett, and Glen Jenkins
- Subjects
Visual acuity ,genetic structures ,Vision Disorders ,Visual Acuity ,Retinal Neovascularization ,Blindness ,Article ,chemistry.chemical_compound ,Macula Lutea ,Optical coherence tomography ,Retinal Diseases ,Foveal ,Medicine ,Humans ,Incontinentia Pigmenti ,Fluorescein Angiography ,Retrospective Studies ,Retina ,medicine.diagnostic_test ,business.industry ,Retinal Detachment ,Infant ,Retinal ,Incontinentia pigmenti ,Anatomy ,Choroid Diseases ,medicine.disease ,Fluorescein angiography ,Magnetic Resonance Imaging ,eye diseases ,Ophthalmology ,medicine.anatomical_structure ,chemistry ,Child, Preschool ,Female ,sense organs ,medicine.symptom ,business ,Tomography, Optical Coherence - Abstract
Importance This report presents evidence from spectral-domain optical coherence tomography and fluorescein angiography of inner foveal structural abnormalities associated with vision loss in incontinentia pigmenti (IP). Observations Two children had reduced visual behavior in association with abnormalities of the inner foveal layers on spectral-domain optical coherence tomography. Fluorescein angiography showed filling defects in retinal and choroidal circulations and irregularities of the foveal avascular zones. The foveal to parafoveal ratios were greater than 0.57 in 6 eyes of 3 patients who had extraretinal neovascularization and/or peripheral avascular retina on fluorescein angiography and were treated with laser. Of these, 3 eyes of 2 patients had irregularities in foveal avascular zones and poor vision. Conclusions and Relevance Besides traction retinal detachment, vision loss in IP can occur with abnormalities of the inner foveal structure seen on spectral-domain optical coherence tomography, consistent with prior descriptions of foveal hypoplasia. The evolution of abnormalities in the neural and vascular retina suggests a vascular cause of the foveal structural changes. More study is needed to determine any potential benefit of the foveal to parafoveal ratio in children with IP. Even with marked foveal structural abnormalities, vision can be preserved in some patients with IP with vigilant surveillance in the early years of life.
- Published
- 2015