Southwest Hospital/Southwest Eye Hospital, Army Medical University (Third Military Medical University) , Chongqing, China.
Curr Eye Res. 2020 Oct;45(10):1222-1227. doi: 10.1080/02713683.2020.1737715. Epub 2020 Mar 13.
: To characterize the lens morphology and to measure the clinical features of familial exudative vitreoretinopathy (FEVR) in children. : Unique lens changes were observed in a cohort of children with FEVR from March 2015 to November 2017 using slit lamp examination and all the patients underwent cycloplegic refraction, ultrasound A and B, keratometry and fundus fluorescein angiography. : Twelve eyes of eight children with FEVR had unique lens changes. The contraction of the posterior capsule caused unique lens changes resulting in myopia in nine eyes of six children and astigmatism in eight eyes of five children. Retinal lesions in the affected eyes were all stage 1 to 2. Six eyes of three patients underwent lensectomy and intraocular lens implantation due to high anisometropia which could not be corrected by conventional optical correction. During lensectomy, the opacification in the posterior capsule was found to be due to the fibrous membrane that protruded into the anterior vitreous and not due to lens opacification. Three patients had bilateral lensectomy, in two of whom significant macular involvement was observed in one eye and in one of whom significant macular involvement was observed in both eyes. After surgery visual acuity (VA) improved obviously in two eyes without significant macular involvement and did not improve in the four eyes which had significant macular involvement. Among the five patients who did not have lensectomy, one patient was lost to follow-up and one patient had VA improved in both eyes without significant macular involvement. The other three patients did not have much change in VA. : Clinicians should be aware that when a high myopia or astigmatism does not match the corneal curvature and the length of the eye, one should check carefully the changes of lens and fundus after dilating the pupil, to avoid misdiagnosis and missed diagnosis.
: 目的:描述 FEVR 患儿晶状体形态并测量其临床特征。 : 2015 年 3 月至 2017 年 11 月,对 8 例 FEVR 患儿的 12 只眼采用裂隙灯检查,所有患者均进行睫状肌麻痹验光、超声 A 超和 B 超、角膜曲率和眼底荧光素血管造影检查,观察晶状体的改变。 : FEVR 患儿的 12 只眼存在独特的晶状体改变。后囊收缩导致晶状体改变,引起 6 例患儿 9 只眼近视,5 例患儿 8 只眼散光。受影响眼的视网膜病变均为 1 期至 2 期。3 例患儿因高度屈光不正(常规光学矫正无法矫正)行晶状体切除术和人工晶状体植入术,其中 6 只眼。术中发现后囊混浊是由于纤维膜向眼前房突出引起的,并非晶状体混浊。3 例患儿行双眼晶状体切除术,其中 2 例患儿一眼有明显黄斑受累,1 例患儿双眼均有明显黄斑受累。术后,2 例无明显黄斑受累眼视力明显提高,4 例有明显黄斑受累眼视力无改善。5 例未行晶状体切除术的患者中,1 例失访,1 例双眼无明显黄斑受累视力提高,3 例视力无明显变化。 : 结论:当高度近视或散光与角膜曲率和眼轴长度不匹配时,临床医生应注意仔细检查瞳孔扩大后的晶状体和眼底变化,以避免误诊和漏诊。