Abstract
Purpose :
Dysfunctional retinal angiogenesis and vitreoretinal traction are known to contribute to the retinal pathology in familial exudative vitreoretinopathy (FEVR). Whether alterations of the natural, age-related process of posterior vitreous detachment (PVD) adds to the risk of retinal detachment in affected individuals is undetermined. PVD advances progressively, and premature PVD is known to create vitreoretinal traction in other conditions.
We performed a case-control study using wide-field spectral domain optical coherence tomography (WF-OCT) to test the hypothesis that PVD progression is accelerated in FEVR patients.
Methods :
Subjects diagnosed with FEVR by their treating physician were prospectively recruited from the University of Utah ophthalmology clinics. Healthy non-diabetic, age-matched within ± 5 years controls without ocular disease, except ocular hypertension, were recruited. Refractive errors were less than 3 diopters of hyperopia, myopia, or astigmatism. WF-OCT was performed with the Heidelberg Spectralis with a 55° lens to capture a single horizontal and a single vertical scan in each eye through the fovea. A single grader (EH) reviewed all WF-OCT scans to determine PVD stage. Stages progress from 0 (none) through 1-3 (partial) to 4 (complete). We analyzed 1 eye per subject, selecting the eye with the highest stage of PVD and performed a Fisher exact test to compare the frequency of stage 1 PVD in the FEVR and control groups.
Results :
We acquired and analyzed scans from 16 FEVR subjects (9 males, 7 females, age 21 ± 13 years (mean ± SD)); and 32 healthy subjects (9 males, 23 females, age 21 ± 13 years).
WF-OCT of FEVR subjects showed that (16) 84% had stage 1 PVD, and 3 (16%) had higher stages of PVD: 1 had stage 3 PVD, 1 had stage 4 PVD, and 1 had anomalous PVD. 38 out of 38 healthy age-matched controls were observed to have stage 1 PVD (100%). The percentage of FEVR subjects with higher stages of PVD (greater than stage 1) was significantly greater than the percentage of control subjects (16% vs 0%, p = 0.03).
Conclusions :
Our results are consistent with our hypothesis that individuals with FEVR have more advanced stages of PVD, which is known to lead to retinal traction, suggesting that accelerated PVD may play a role in the pathogenesis of retinal disease in FEVR.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.