Advertisement

Functional and anatomical outcomes following surgical management of persistent fetal vasculature: a single-center experience of 44 cases

  • Murat KaracorluEmail author
  • Mumin Hocaoglu
  • Isil Sayman Muslubas
  • Serra Arf
  • Mehmet Giray Ersoz
  • Omer Uysal
Retinal Disorders

Abstract

Purpose

To investigate the functional and anatomical outcomes following surgical management of persistent fetal vasculature (PFV).

Methods

Single-center, retrospective, interventional consecutive case series of 41 patients (44 eyes) who underwent vitrectomy with or without lensectomy through a limbal or pars plana/plicata approach with diagnosis of anterior, posterior, or combined anterior and posterior segment PFV were included.

Results

The median age at the time of surgery was 3 months (range, 1–36 months), and the mean follow-up period was 37.2 ± 38.1 months (range, 12–164 months). Of the 44 eyes, 5 (11%) had clinical and ultrasonographic findings of anterior PFV, 5 (11%) had posterior PFV, and 34 (78%) had components of both anterior and posterior disease. At the last visit, 38 eyes (87%) were aphakic, 5 eyes (11%) were phakic, and 1 eye (2%) was pseudophakic. The mean Snellen equivalent VA at the final visit for the 14 (32%) eyes with measurable VA was 20/283. Nine (20%) eyes had final VA of only light perception or no light perception. The remaining 21 (48%) eyes behaved consistently with form vision, but the patients were not able to report VA.

Conclusions

Most of the eyes achieved at least form vision, with acceptable postoperative complication rates. Functional and anatomical outcomes are not strictly dependent on axial length, and microphthalmic eyes with mild posterior segment involvement have the potential for good visual results. Outcomes after surgery for posterior PFV associated with tractional retinal detachment are limited. Anatomical success does not always equate to functional improvement.

Keywords

Pediatric vitrectomy Persistent fetal vasculature Persistent hyperplastic primary vitreous Tractional retinal detachment 

Notes

Compliance with ethical standards

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.

References

  1. 1.
    Reese AB (1955) Persistent hyperplastic primary vitreous. Jackson memorial lecture. Trans Am Acad Ophthalmol Otolaryngol 59:271–295PubMedGoogle Scholar
  2. 2.
    Goldberg MF (1997) Persistent fetal vasculature (PFV): an integrated interpretation of signs and symptoms associated with persistent hyperplastic primary vitreous (PHPV). LIV Edward Jackson memorial lecture. Am J Ophthalmol 124:587–626CrossRefPubMedGoogle Scholar
  3. 3.
    Kaste SC, Jenkins JJ 3rd, Meyer D, Fontanesi J, Pratt CB (1994) Persistent hyperplastic primary vitreous of the eye: imaging findings with pathologic correlation. AJR 162:437–440CrossRefPubMedGoogle Scholar
  4. 4.
    Cerón O, Lou PL, Kroll AJ, Walton DS (2008) The vitreo-retinal manifestations of persistent hyperplasic primary vitreous (PHPV) and their management. Int Ophthalmol 48:53–62CrossRefGoogle Scholar
  5. 5.
    Shastry BS (2009) Persistent hyperplastic primary vitreous: congenital malformation of the eye. Clin Exp Ophthalmol 37:884–890CrossRefPubMedGoogle Scholar
  6. 6.
    Fei P, Zhang Q, Li J, Zhao P (2013) Clinical characteristics and treatment of 22 eyes of morning glory syndrome associated with persistent hyperplastic primary vitreous. Br J Ophthalmol 97:1262–1267CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Tartarella MB, Takahagi RU, Braga AP, Fortes Filho JB (2013) Persistent fetal vasculature: ocular features, management of cataract and outcomes. Arq Bras Oftalmol 76:185–188CrossRefPubMedGoogle Scholar
  8. 8.
    Anteby I, Cohen E, Karshai I, BenEzra D (2002) Unilateral persistent hyperplastic primary vitreous: course and outcome. J AAPOS 6:92–99CrossRefPubMedGoogle Scholar
  9. 9.
    Hunt A, Rowe N, Lam A, Martin F (2005) Outcomes in persistent hyperplastic primary vitreous. Br J Ophthalmol 89:859–863CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Sisk RA, Berrocal AM, Feuer WJ, Murray TG (2010) Visual and anatomic outcomes with or without surgery in persistent fetal vasculature. Ophthalmology 117:2178–2183CrossRefPubMedGoogle Scholar
  11. 11.
    Pollard ZF (1997) Persistent hyperplastic primary vitreous: diagnosis, treatment, and results. Trans Am Ophthalmol Soc 95:487–549PubMedPubMedCentralGoogle Scholar
  12. 12.
    Bosjolie A, Ferrone P (2015) Visual outcome in early vitrectomy for posterior persistent fetal vasculature associated with traction retinal detachment. Retina 35:570–576CrossRefPubMedGoogle Scholar
  13. 13.
    Hellström A, Svensson E, Strömland K (1997) Eye size in healthy Swedish children and in children with fetal alcohol syndrome. Acta Ophthalmol Scand 75:423–428CrossRefPubMedGoogle Scholar
  14. 14.
    Pennie FC, Wood IC, Olsen C, White S, Charman WN (2001) A longitudinal study of the biometric and refractive changes in full-term infants during the first year of life. Vis Res 41:2799–2810CrossRefPubMedGoogle Scholar
  15. 15.
    Johnson CP, Keech RV (1996) Prevalence of glaucoma after surgery for PHPV and infantile cataracts. J Pediatr Ophthalmol Strabismus 33:14–17PubMedGoogle Scholar
  16. 16.
    Walsh MK, Drenser KA, Capone A, Trese MT (2010) Early vitrectomy effective for bilateral combined anterior and posterior persistent fetal vasculature syndrome. Retina 30:2–8CrossRefGoogle Scholar
  17. 17.
    Schulz E, Griffiths B (2006) Long-term visual function and relative amblyopia in posterior persistent hyperplastic primary vitreous (PHPV). Strabismus 14:121–125CrossRefPubMedGoogle Scholar
  18. 18.
    Dass AB, Trese MT (1999) Surgical results of persistent hyperplastic primary vitreous. Ophthalmology 106:280–284CrossRefPubMedGoogle Scholar
  19. 19.
    Lakhanpal RR, Sun RL, Albini TA, Coffee R, Coats DK, Holz ER (2006) Visual outcomes after 3-port lens-sparing vitrectomy in stage 4 retinopathy of prematurity. Arch Ophthalmol 124:675–679CrossRefPubMedGoogle Scholar
  20. 20.
    Mocan MC, Najera-Covarrubias M, Wright KW (2005) Comparison of visual acuity levels in pediatric patients with amblyopia using Wright figures, Allen optotypes, and Snellen letters. J AAPOS 9:48–52CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Murat Karacorlu
    • 1
    Email author
  • Mumin Hocaoglu
    • 1
  • Isil Sayman Muslubas
    • 1
  • Serra Arf
    • 1
  • Mehmet Giray Ersoz
    • 1
  • Omer Uysal
    • 2
  1. 1.Istanbul Retina InstituteIstanbulTurkey
  2. 2.School of Medicine, Deparment of BiostatisticsBezmialem Vakif UniversityIstanbulTurkey

Personalised recommendations