May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Retinal Detachment with Macular Hole in Infants with Retinopathy of Prematurity
Author Affiliations & Notes
  • O. Ahmad
    Schepens Retina Associates, Mass. Eye and Ear Infirmary, Boston, MA
  • T. Hirose
    Schepens Retina Associates, Mass. Eye and Ear Infirmary, Boston, MA
  • Footnotes
    Commercial Relationships  O. Ahmad, None; T. Hirose, None.
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 4031. doi:
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      O. Ahmad, T. Hirose; Retinal Detachment with Macular Hole in Infants with Retinopathy of Prematurity . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4031.

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Abstract

Abstract: : Purpose: To describe retinal detachment (RD) with macular holes in infants with retinopathy of prematurity (ROP) and the methods of surgical repair with their outcomes. Methods: A retrospective review of four cases of ROP and one case of a retinopathy resembling ROP, in which macular hole and associated RD developed and surgical repair was attempted. Results: Average gestational age of the four ROP infants was 26 weeks. Four of the five patients had a history of vitreo–retinal surgery for repair of the retinal detachment prior to the development of a macular hole. All four that underwent further surgical correction have partially or completely attached retinas and ambulatory vision. Scleral buckling was partially successful in one case and completely successful in two cases. Vitrectomy with use of cyanoacrylate glue was unsuccessful as was vitrectomy with fluid – air exchange. Conclusion: Retinal detachments with macular holes can occur in infants with retinopathy of prematurity. Repair of these detachments is not straightforward and may require different techniques than those used in adult detachments. Vitrectomy combined with fluid–air exchange or cyanoacrylate glue failed to close a macular hole associated with retinal detachment in ROP infants. This might be due to inability to adequately relieve all anterior traction on the retina. In fact, in the case of the fluid– air exchange, the macular hole was enlarged greatly. Athermal scleral buckling of the macula can close macular holes and re–attach the retina. This technique was combined with circumferential buckling and had the greatest success in our cases.

Keywords: retinopathy of prematurity • retinal detachment 
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