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Severe anterior persistent fetal vasculature: the role of anterior retinal elongation on prognosis

  • Retinal Disorders
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Abstract

Purpose

This study aims to investigate surgical outcomes of eyes with severe anterior persistent fetal vasculature (PFV) and the role of associated anatomical anomalies on prognosis.

Methods

This is a retrospective, comparative case series of 32 eyes of 31 patients who underwent vitreoretinal surgery for severe anterior PFV, defined as fibrovascular tissue totally covering the back of cataractous lens. Based on the degree of anterior retinal elongations, cases were classified as follows: group 1, eyes with well-developed pars plana and minor/no abnormalities (n = 11, 34%); group 2, eyes with partially developed pars plana and broad-based elongations (n = 9, 28%); and group 3, eyes with no visible pars plana and fibrovascular membrane having 360° continuity with peripheral retina (n = 12, 38%). Complications and functional and anatomical outcomes were investigated.

Results

The median surgical age was 2 (1–12) months. The median follow-up was 26 (6–120) months. Seventy-three percent in group 1 achieved finger counting or better vision with a single surgery and without any pupillary/retinal complication. Groups 2 and 3 required 2.1 ± 0.9 and 2.6 ± 1.2 surgeries on average. Pupillary obliteration and RD occurred in 33% and 22% in group 2 and 58% and 67% in group 3. Retina remained attached after silicone oil removal in 89% of group 2 and 25% of group 3. Phthisis developed in 50% in group 3.

Conclusion

Peripheral retinal anomalies are common in severe anterior PFV and have a major impact on prognosis. Prognosis is favorable in cases with mild-to-moderate anomalies with appropriate management of possible retinal tears. In eyes with 360° retinal elongations, severe fibrous proliferation and eventual eye loss are common.

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Data availability

Data is be available upon request.

Code availability

Not applicable.

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Authors and Affiliations

  1. Ankara Retina Clinic, Ankara, 06500, Turkey

    Ece Ozdemir Zeydanli & Sengul Ozdek

  2. Department of Ophthalmology, Gazi University School of Medicine, Ankara, 06500, Turkey

    Sengul Ozdek, Burak Acar, Huseyin Baran Ozdemir & Hatice Tuba Atalay

Authors
  1. Ece Ozdemir Zeydanli
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  2. Sengul Ozdek
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  3. Burak Acar
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  4. Huseyin Baran Ozdemir
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  5. Hatice Tuba Atalay
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Contributions

All authors contributed to the study conception and design. Surgeries were performed by Dr. Ş. Özdek; material preparation and data collection were performed by Ece Ozdemir Zeydanli, Sengul Ozdek, Burak Acar, Huseyin Baran Ozdemir, and Hatice Tuba Atalay. The first draft of the manuscript and statistical analysis were done by Ece Ozdemir Zeydanli, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sengul Ozdek.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Gazi University (Ethical approval number: E-77082166–604.01.02–571072) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare no competing interests.

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A brief report of this manuscript has been presented in the Turkish Ophthalmological Association 56th National Congress in November 2022.

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Ozdemir Zeydanli, E., Ozdek, S., Acar, B. et al. Severe anterior persistent fetal vasculature: the role of anterior retinal elongation on prognosis. Graefes Arch Clin Exp Ophthalmol 261, 2795–2804 (2023). https://doi.org/10.1007/s00417-023-06114-0

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  • DOI: https://doi.org/10.1007/s00417-023-06114-0

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