Abstract
Purpose::
To report the anatomical and visual outcomes following pars plana vitrectomy with membrane peeling of combined hamartomas of the retina and retinal pigment epithelium (RPE).
Methods::
We retrospective reviewed the results of 8 eyes with combined retinal-RPE hamartomas that underwent pars plana vitrectomy and membrane peeling with or without autologous plasmin enzyme. Patients were evaluated by complete ophthalmoscopic examination, fluorescein angiography (FA) and optical coherence tomography (OCT) both pre and postoperatively. Primary outcomes were anatomical success defined as retinal reattachment and stabilization of visual acuity. Secondary outcomes included improvement of macular architecture by FA and OCT.
Results::
The mean age of the patients was 4.2 years (range 1 to 7). Mean follow up was 10.75 months (range 1 to 36 months). The lesions were located solely in the macula in 5/8(62.5%) and in the macula and posterior pole in 3/8 (37.5%) patients. Of the 8 eyes, 3 underwent preoperative injection of autologous plasmin enzyme to assist in removal of the posterior hyloid face. 8/8 patients (100%) had complete retinal reattachment immediately post operatively. Six patients (75%) improved or maintained visual acuity postoperatively, 2 patient showed a two line decline in visual acuity. 6 eyes required only one surgery and At 12 months, 4/8 patents (50%) had recurrences of epiretinal membrane 2/8 (25%) requiring additional surgery.
Conclusions::
Pars plana with membrane peeling for combined retinal-RPE hamartomas can result in anatomical stabilization of macular function. Although, other reports have described limited visual outcomes, here we report stabilized or improved vision in the majority of patients.
Keywords: retina • macula/fovea • development