Tartarella Marcia Beatriz, Takahagi Rodrigo Ueno, Braga Ana Paula, Fortes Filho João Borges
Department of Ophthalmology, School of Medicine, Universidade Federal de São Paulo, São Paulo (SP), Brazil.
Arq Bras Oftalmol. 2013 May-Jun;76(3):185-8. doi: 10.1590/s0004-27492013000300011.
To describe ocular features, management of cataract and functional outcomes in patients with persistent fetal vasculature.
Retrospective, descriptive case series of patients with persistent fetal vasculature. Data were recorded from the Congenital Cataract Section of Federal University of São Paulo, Brazil from 2001 to 2012. All patients were evaluated for sex, age at diagnosis, systemic findings, laterality, age at surgery, and initial and final follow-up visual acuities. Follow-up and complications after cataract surgery were recorded. Ultrasound was performed in all cases and ocular eco-Doppler was performed in most.
The study comprised 53 eyes from 46 patients. Age at diagnosis ranged from 5 days of life to 10 years-old (mean 22.7 months). Twenty-seven patients were male (58.7%). Persistent fetal vasculature was bilateral in 7 patients (15.2%). Forty-two eyes (79.2%) had combined (anterior and posterior forms) PFV presentation, 5 eyes (9.4%) had only anterior persistent fetal vasculature presentation and 6 eyes (11.3%) had posterior persistent fetal vasculature presentation. Thirty-eight eyes (71.7%) were submitted to cataract surgery. Lensectomy combined with anterior vitrectomy was performed in 18 eyes (47.4%). Phacoaspiration with intraocular lens implantation was performed in 15 eyes (39.5%), and without lens implantation in 5 eyes (13.2%). Mean follow-up after surgery was 44 months. Postoperative complications were posterior synechiae (3 cases), retinal detachment (2 cases), phthisis (3 cases), posterior capsular opacification (8 cases), inflammatory pupillary membrane (5 cases), glaucoma (4 cases), intraocular lens implantation displacement (1 case) and vitreous hemorrhage (2 cases). Complications were identified in 19 (50%) of the 38 operated eyes. Visual acuity improved after cataract surgery in 83% of the eyes.
Patients with persistent fetal vasculature have variable clinical presentation. There is an association of persistent fetal vasculature with congenital cataract. Severe complications are related to cataract surgery in patients with persistent fetal vasculature, but 83% of the operated eyes improved visual acuity.
描述永存原始玻璃体增生症患者的眼部特征、白内障治疗方法及功能预后。
对永存原始玻璃体增生症患者进行回顾性描述性病例系列研究。数据来自巴西圣保罗联邦大学先天性白内障科室2001年至2012年期间的病例。对所有患者的性别、诊断时年龄、全身检查结果、病变眼别、手术年龄以及初次和末次随访视力进行评估。记录白内障手术后的随访情况及并发症。所有病例均进行了超声检查，大多数病例还进行了眼部彩色多普勒超声检查。
该研究纳入了46例患者的53只眼。诊断时年龄范围为出生5天至10岁（平均22.7个月）。27例患者为男性（58.7%）。7例患者（15.2%）的永存原始玻璃体增生症为双眼病变。42只眼（79.2%）表现为联合型（前部和后部型）永存原始玻璃体增生症，5只眼（9.4%）仅表现为前部永存原始玻璃体增生症，6只眼（11.3%）表现为后部永存原始玻璃体增生症。38只眼（71.7%）接受了白内障手术。18只眼（47.4%）进行了晶状体切除术联合前部玻璃体切除术。15只眼（39.5%）进行了超声乳化白内障吸除联合人工晶状体植入术，5只眼（13.2%）未植入人工晶状体。手术后平均随访44个月。术后并发症包括虹膜后粘连（3例）、视网膜脱离（2例）、眼球痨（3例）、后囊膜混浊（8例）、炎性瞳孔膜（5例）、青光眼（4例）、人工晶状体植入移位（1例）和玻璃体积血（2例）。38只手术眼中有19只眼（50%）出现了并发症。白内障手术后83%的患眼视力得到改善。
永存原始玻璃体增生症患者临床表现多样。永存原始玻璃体增生症与先天性白内障有关。永存原始玻璃体增生症患者白内障手术相关的严重并发症较多，但83%的手术患眼视力得到改善。
