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M. C. Ashwin, N. N. Tehrani, W.-C. Lam; Asymmetry of Severity of Retinopathy of Prematurity (ROP) Associated with Persistent Fetal Vasculature (PFV). Invest. Ophthalmol. Vis. Sci. 2008;49(13):1396.
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ROP is a disease of premature infants, which usually presents with symmetrical severity in both eyes of the affected infants. We report two infants referred to our clinic in whom the micro-ophthalmic eye with PFV developed mild ROP whilst the eye without PFV developed moderate to severe ROP.
We report the clinical course in two infants who developed asymmetrical ROP. Both infants were referred to our tertiary clinic because of poor pupillary dilation and hazy media preventing adequate ophthalmic examination in one eye at the initial ophthalmic examination in the referring center.
Case 1: Baby girl born at 24 weeks five days, 828grams, referred for evaluation on day 41 showed poor pupillary dilation and a white mass with intralesional blood in the temporal periphery of right eye. The left eye was vascularized to zone II, no ROP on initial exam. MRI scan confirmed right micro-ophthalmia with no evidence of intracranial calcification. Serology was negative for TORCH screen. Maturation resulted in development of stage 2 ROP, zone II in the non PFV eye which later regressed spontaneously. No ROP developed in the PFV eye but intralesional bleeding was associated with traction on the peripheral retina and macula ectopia.Case 2: Baby boy (triplet, assisted pregnancy) born by Caesarian section at 26 weeks and 910 grams. Referral made to our clinic on day 55, examination showed right PFV associated cataract in a micro-ophthalmic eye with no ROP and incomplete vascularization of the retina. The left eye showed stage 2 ROP in posterior zone II, no plus disease. Review one week later showed stage 1, zone II no plus in the right eye and stage 3 posterior zone II with plus disease in left eye. B scan revealed two areas of attachment between the retina and the posterior surface of the lens in the PFV eye. Laser treatment was performed in left eye.
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