Dave Vivek Pravin, Jalali Subhadra, Rani Padmaja Kumari, Padhi Tapas Ranjan
Srimati Kanuri Santhamma Centre for Vitreoretinal Diseases, LV Prasad Eye Institute, Kallam Anji Reddy Campus, LV Prasad Marg, Banjara Hills, Hyderabad, 500034, India.
Int Ophthalmol. 2014 Jun;34(3):511-7. doi: 10.1007/s10792-013-9843-2. Epub 2013 Sep 14.
To describe the characteristics and treatment outcomes of an unreported, late vitreous hemorrhage due to anterior hyaloidal fibrovascular proliferation in laser-regressed retinopathy of prematurity (ROP). Interventional case series. In the ongoing Indian Twin Cities ROP study database, consecutive cases with isolated late vitreous hemorrhage at least one year after laser-regressed disease were analyzed retrospectively. Anterior hyaloidal fibrovascular proliferation was diagnosed primarily using scleral depression. Anterior retinal cryopexy with adjunctive treatments was performed. The main outcome measure was clinical resolution of new vessels with no recurrent hemorrhage over a 1-year period. Vitreous hemorrhage, at two to eight years of age, developed in three eyes of three children out of 1,168 ROP lasered eyes. All had received laser for zone I disease as neonates, with no subsequent sequelae. Evaluation revealed filiform new vessels at the posterior vitreous base involving inferior 180° with absence of any other source of hemorrhage. All underwent anterior retinal cryopexy to the affected area. Simultaneous additional treatment, based on intraoperative findings, included one case each of peripheral laser photocoagulation, lens-sparing vitrectomy and intravitreal bevacizumab. All three showed successful regression and non-recurrence of vitreous hemorrhage with improvement of vision >20/40 at an intermediate follow-up of two years. Anterior hyaloidal fibrovascular proliferation is an unreported and rare cause of vitreous hemorrhage, appearing years after laser-regressed ROP. It has a good response to interventional treatment. Meticulous scleral depression of the vitreous base under anesthesia is useful to detect this rare source of vitreous hemorrhage.
描述未报告的、因激光治疗后早产儿视网膜病变（ROP）中前玻璃体纤维血管增殖导致的晚期玻璃体出血的特征和治疗结果。干预性病例系列研究。在正在进行的印度双城ROP研究数据库中，对激光治疗后至少一年出现孤立性晚期玻璃体出血的连续病例进行回顾性分析。主要通过巩膜压迫诊断前玻璃体纤维血管增殖。进行了视网膜前部冷冻治疗及辅助治疗。主要观察指标为新生血管在1年期间临床消退且无复发性出血。在1168只接受激光治疗的ROP眼中，3名儿童的3只眼在2至8岁时出现玻璃体出血。所有患儿均在新生儿期接受过I区疾病的激光治疗，且无后续后遗症。评估发现后玻璃体基底部有丝状新生血管，累及下方180°，无任何其他出血来源。所有患儿均对受累区域进行了视网膜前部冷冻治疗。根据术中发现，同时进行的额外治疗包括1例周边激光光凝、1例保留晶状体的玻璃体切除术和1例玻璃体内注射贝伐单抗。在两年的中期随访中，所有3例均显示玻璃体出血成功消退且无复发，视力提高至>20/40。前玻璃体纤维血管增殖是一种未报告的、罕见的玻璃体出血原因，出现在激光治疗后的ROP数年之后。它对介入治疗反应良好。在麻醉下对玻璃体基底部进行细致的巩膜压迫有助于发现这种罕见的玻璃体出血来源。
