Abstract
Purpose
To evaluate the outcome for vitreoretinal surgery in children with familial exudative vitreoretinopathy (FEVR) and to evaluate the risk factors associated with failure.
Methods
This is a retrospective interventional case series of 43 consecutive eyes (34 patients) with vitreoretinal surgery for FEVR. Ocular status prior to intervention and at last follow-up and all surgical steps were recorded. Follow-up time was at least 6 months. Main outcome measure was surgical failure (defined as one of the following: (1) deterioration of visual acuity and stage, (2) persistence or development of total retinal detachment, (3) phthisis).
Results
After a mean follow-up of 3.3 ± 3.4 years (median 2.3; 0.5–15.7 years), surgery was successful in 30 eyes (70%) and failed in 13 eyes (30%). Twenty-one eyes (49%) improved, 13 (30%) remained stable, and 9 (21%) deteriorated. Postoperatively, stages and VA improved significantly (p = 0.001; p = 0.04, respectively). Surgical failure was only observed on patients with stages 4 and 5. Mean macular thickness decreased significantly in eyes (stages 2 and 3) with tractional epiretinal membrane.
Conclusion
Eyes with tractional epiretinal membrane in stages 2 and 3 seem to benefit from vitrectomy and membrane peeling with a positive risk-benefit profile. Advanced stages have a low success rate and limited functional improvement, but in selected cases, surgery seems beneficial.
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References
Criswick VG, Schepens CL (1969) Familial exudative vitreoretinopathy. Am J Ophthalmol 68(4):578–594
Ranchod TM, Ho LY, Drenser KA, Capone A Jr, Trese MT (2011) Clinical presentation of familial exudative vitreoretinopathy. Ophthalmology 118(10):2070–2075. https://doi.org/10.1016/j.ophtha.2011.06.020
Miyakubo H, Hashimoto K, Miyakubo S (1984) Retinal vascular pattern in familial exudative vitreoretinopathy. Ophthalmology 91(12):1524–1530
Benson WE (1995) Familial exudative vitreoretinopathy. Trans Am Ophthalmol Soc 93:473–521
Hocaoglu M, Karacorlu M, Muslubas IS, Ersoz MG, Arf S (2016) Anatomical and functional outcomes following vitrectomy for advanced familial exudative vitreoretinopathy: a single surgeon’s experience. British Journal of Ophthalmology:bjophthalmol-2016-309526
Gilmour D (2015) Familial exudative vitreoretinopathy and related retinopathies. Eye 29(1):1
Pendergast SD, Trese MT (1998) Familial exudative vitreoretinopathy. Results of surgical management. Ophthalmology 105(6):1015–1023. https://doi.org/10.1016/s0161-6420(98)96002-x
Glazer LC, Maguire A, Blumenkranz MS, Trese MT, Green WR (1995) Improved surgical treatment of familial exudative vitreoretinopathy in children. Am J Ophthalmol 120(4):471–479
Shukla D, Singh J, Sudheer G, Soman M, John RK, Ramasamy K, Perumalsamy N (2003) Familial exudative vitreoretinopathy (FEVR). Clinical profile and management. Indian J Ophthalmol 51(4):323
Ikeda T, Fujikado T, Tano Y, Tsujikawa K, Koizumi K, Sawa H, Yasuhara T, Maeda K, Kinoshita S Vitrectomy for rhegmatogenous or tractional retinal detachment with familial exudative vitreoretinopathy. Ophthalmology 106(6):1081–1085. https://doi.org/10.1016/S0161-6420(99)90268-3
Shubert A, Tasman W (1997) Familial exudative vitreoretinopathy: surgical intervention and visual acuity outcomes. Graefes Arch Clin Exp Ophthalmol 235(8):490–493. https://doi.org/10.1007/bf00947005
Gow J, Oliver GL (1971) Familial exudative vitreoretinopathy: an expanded view. Arch Ophthalmol 86(2):150–155
Lange C, Feltgen N, Junker B, Schulze-Bonsel K, Bach M (2009) Resolving the clinical acuity categories “hand motion” and “counting fingers” using the Freiburg Visual Acuity Test (FrACT). Graefes Arch Clin Exp Ophthalmol 247(1):137–142
Holladay JT (2004) Visual acuity measurements. J Cataract Refract Surg 30(2):287–290. https://doi.org/10.1016/j.jcrs.2004.01.014
Machemer R, Williams JM Sr (1988) Pathogenesis and therapy of traction detachment in various retinal vascular diseases. Am J Ophthalmol 105(2):170–181
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el-Khoury, S., Clement, A., Chehaibou, I. et al. Outcome and risk factors of vitreoretinal surgery in pediatric patients with familial exudative vitreoretinopathy. Graefes Arch Clin Exp Ophthalmol 258, 1617–1623 (2020). https://doi.org/10.1007/s00417-020-04712-w
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DOI: https://doi.org/10.1007/s00417-020-04712-w