Purchase this article with an account.
Angela L. Bosjolie, Philip Ferrone; Visual Outcome with Early Vitrectomy for Posterior Persistent Fetal Vasculature Syndrome Associated with Traction Retinal Detachment. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6174.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
This study evaluated the anatomic/ visual outcome of vitrectomy for the treatment of posterior Persistent Fetal Vasculature Syndrome (PFVS) with Traction Retinal Detachment (TRD) in very young patients.
Retrospective, consecutive, case series of 9 eyes in 9 patients who underwent pars plana vitrectomy (PPV), with or without lensectomy for PFVS with TRD at less than 6 months old. Vision and anatomical status was recorded.
The average age at surgery was 3 months (range 1 to 5.5 months). The average postoperative follow up time was 31 months (range 2 to 72 months). The average age at last follow up was 33 months (range of 6 to 72 months). Six eyes underwent a lens sparing vitrectomy (LSV), and three eyes underwent PPV with lensectomy for visually significant cataract. Five eyes out of nine (56%) had functional visual acuity (20/800 or better). Two of these five eyes had vision that measured 20/60. Of the remaining 4 eyes, 1 eye had vision of Central, Steady, Maintained (CSM), 1 eye had Central, Steady vision only, 1 eye had Central vision only, and the remaining eye had only Light Perception vision. All patients had their retina reattached postoperatively with significant reversal of retinal dragging. Three patients had small residual peripapillary retinal folds. Postoperative glaucoma was detected in 4 patients (44%). Two of these patients were aphakic, and two required only topical drops for intraocular pressure (IOP) control. Two cases required glaucoma tube surgery for adequate IOP control. Progression of cataract was seen in one of the six (17%) phakic patients.
Patients with posterior PFV with associated TRD can obtain functional visual acuity when vitrectomy and retinal reattachment are performed within the first six months of life. Severing the vitreous stalk allows the infant retina to relax back to a more normal position. This is thought to be due to inherent elasticity of the infant retina, similar to that seen in retinopathy of prematurity. This reversal of retinal dragging has not been reported in older patients with this condition who are treated surgically.
This PDF is available to Subscribers Only