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Early laser photocoagulation for extensive retinal avascularity in infants with incontinentia pigmenti

Japanese Journal of Ophthalmology volume 64, pages 613–620 (2020)Cite this article

Abstract

Purpose

To describe the clinical features and treatment outcomes of severe retinopathy in eyes with incontinentia pigmenti (IP) of infants within a few months of birth.

Study design

Retrospective clinical study.

Methods

Six eyes of three patients (6-day-old girl, 5-month-old girl, and 14-day-old boy) with IP were examined and treated under general anesthesia. Ophthalmologic examinations were performed including images from wide-angle fluorescein angiography (FA), swept-source optical coherence tomography (OCT), and OCT angiography (OCTA).

Results

Ophthalmoscopy showed prominent vascular tortuosity in five eyes, retinal hemorrhages in four eyes, and incomplete vascular development in two eyes. FA showed extensive avascularity including the posterior pole of the retina in all cases except one eye. Prompt and intensive laser photocoagulation stabilized the pre-proliferative severe retinopathy in five eyes; however, foveal structure and vessel anomalies were detected in three of six eyes by OCT and two of five eyes by OCTA.

Conclusion

Severe retinopathy in the neonatal period and infancy was present not only in the periphery but also in the posterior pole including the fovea, which might be related to retinal vascular maldevelopment. It is, therefore, recommended that wide-angle fundus FA examination be performed in the early postnatal period to detect early signs of severe retinopathy in infants with IP.

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Acknowledgements

We thank the patients and their parents/guardians for participating in this study. This work was supported by grants from the National Center for Child Health and Development 28-2 and the Japan Agency for Medical Research and Development 19gk0110034h0002.

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Affiliations

  1. Laboratory for Visual Science, Department of Ophthalmology, National Center for Child Health and Development, 2-10-1 Okura Setagaya-ku, Tokyo, Japan

    Shiro Nakao, Sachiko Nishina, Shin Tanaka, Tomoyo Yoshida, Tadashi Yokoi & Noriyuki Azuma

Authors
  1. Shiro Nakao
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  2. Sachiko Nishina
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  3. Shin Tanaka
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  4. Tomoyo Yoshida
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  5. Tadashi Yokoi
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  6. Noriyuki Azuma
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Corresponding author

Correspondence to Noriyuki Azuma.

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Conflicts of interest

S. Nakao, None; S. Nishina, None; S. Tanaka, None; T. Yoshida, None; T. Yokoi, None; N. Azuma, None.

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Corresponding Author: Noriyuki Azuma

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Nakao, S., Nishina, S., Tanaka, S. et al. Early laser photocoagulation for extensive retinal avascularity in infants with incontinentia pigmenti. Jpn J Ophthalmol 64, 613–620 (2020). https://doi.org/10.1007/s10384-020-00768-7

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  • DOI: https://doi.org/10.1007/s10384-020-00768-7

Keywords

  • Incontinentia pigmenti
  • Retinopathy
  • Laser photocoagulation
  • Fluorescein angiography
  • Optical coherence tomography