July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Early Diagnosis and Management of Aggressive Posterior Neonatal Vitreoretinopathy Presenting in Premature Neonates
Author Affiliations & Notes
  • Samir N Patel
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Mrinali Patel Gupta
    Department of Ophthalmology, Weill Cornell Medical College, New York, New York, United States
  • Irene Rusu
    Department of Ophthalmology, Weill Cornell Medical College, New York, New York, United States
  • Yoshihiro Yonekawa
    Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States
  • Karyn Jonas
    Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, United States
  • Erica Oltra
    Department of Ophthalmology, Weill Cornell Medical College, New York, New York, United States
  • Anton Orlin
    Department of Ophthalmology, Weill Cornell Medical College, New York, New York, United States
  • Jonathan S Chang
    Department of Ophthalmology, University of Wisconsin, Madison, Wisconsin, United States
  • Jason Horowitz
    Department of Ophthalmology, Columbia University, New York, New York, United States
  • Antonio Capone
    Associated Retinal Consultants, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, United States
  • Robison Vernon Paul Chan
    Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, United States
  • Footnotes
    Commercial Relationships   Samir Patel, None; Mrinali Patel Gupta, None; Irene Rusu, None; Yoshihiro Yonekawa, None; Karyn Jonas, None; Erica Oltra, None; Anton Orlin, None; Jonathan Chang, None; Jason Horowitz, None; Antonio Capone, None; Robison Chan, Visunex Medical Systems (Fremont, California) (S)
  • Footnotes
    Support  1) P30 EY001792; 2) Unrestricted departmental funding from Research to Prevent Blindness, New York, NY
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 3758. doi:
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      Samir N Patel, Mrinali Patel Gupta, Irene Rusu, Yoshihiro Yonekawa, Karyn Jonas, Erica Oltra, Anton Orlin, Jonathan S Chang, Jason Horowitz, Antonio Capone, Robison Vernon Paul Chan; Early Diagnosis and Management of Aggressive Posterior Neonatal Vitreoretinopathy Presenting in Premature Neonates. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3758.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : We report a case series of advanced ischemic vitreoretinopathies in premature infants that were more consistent with familial exudative vitreoretinopathy (FEVR) than with retinopathy of prematurity (ROP).

Methods : The charts of three consecutive patients who met ROP screening criteria and were diagnosed with FEVR-like, non-ROP aggressive posterior neonatal vitreoretinopathy were retrospectively reviewed.

Results : Table 1 shows clinical characteristics of each case. Severe, rapidly progressive retinal vascular abnormalities were noted in all cases (Figure 1). Average time to intervention (laser or surgery) was 39 weeks gestational age (range 35-46), and prompt treatment resulted in anatomic stabilization or improvement in the retinal detachment and maintenance of at least light perception vision in all cases.

Conclusions : This series supports the existence of a clinical entity more consistent with a FEVR-like ischemic vitreoretinopathy than ROP in premature infants and suggests that early diagnosis and intervention may mitigate the typical aggressive course and poor prognosis of this condition.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Clinical characteristics of three cases of premature infants diagnosed with a non-ROP aggressive posterior neonatal vitreoretinopathy

Clinical characteristics of three cases of premature infants diagnosed with a non-ROP aggressive posterior neonatal vitreoretinopathy

 

Case 1- Membrane over the disc with macular detachment, retinal dysplasia, and avascularity OU (A-OD, C-OS). FA with marked avascularity, irregular sprouts of neovascularization along the vascular-avascular border, and pinpoint hyperfluorescence beyond the transition zone OU (B: OD, 12sec; D: OS, 82sec). Case 2- Retinal dysplasia with anomalous retinal vasculature and membrane over the disc and arcades with nasal retinal detachment OU (E: OD, G: OS). FA with severe retinal avascularity with irregular sprouts of vascularization beyond the vascular-avascular transition zone and neovascularization over the disc and arcades OU (F: OD, 9sec; H: OS, 42sec). Case 3- Macular tractional retinal detachment OD (I) and unremarkable OS (K). FA revealed severe retinal avascularity OD (J: 1min, 26sec) with bulbous vascular terminals, pinpoint areas of hyperfluorescence beyond the transition zone, and neovascularization from the disc to the temporal avascular-vascular junction; and peripheral avascularity OS (L: 5min, 56sec)

Case 1- Membrane over the disc with macular detachment, retinal dysplasia, and avascularity OU (A-OD, C-OS). FA with marked avascularity, irregular sprouts of neovascularization along the vascular-avascular border, and pinpoint hyperfluorescence beyond the transition zone OU (B: OD, 12sec; D: OS, 82sec). Case 2- Retinal dysplasia with anomalous retinal vasculature and membrane over the disc and arcades with nasal retinal detachment OU (E: OD, G: OS). FA with severe retinal avascularity with irregular sprouts of vascularization beyond the vascular-avascular transition zone and neovascularization over the disc and arcades OU (F: OD, 9sec; H: OS, 42sec). Case 3- Macular tractional retinal detachment OD (I) and unremarkable OS (K). FA revealed severe retinal avascularity OD (J: 1min, 26sec) with bulbous vascular terminals, pinpoint areas of hyperfluorescence beyond the transition zone, and neovascularization from the disc to the temporal avascular-vascular junction; and peripheral avascularity OS (L: 5min, 56sec)

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