Bata Bashar M, Khalili Sina, Ali Asim, Wan Michael J, Mireskandari Kamiar
Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
J AAPOS. 2022 Dec;26(6):296.e1-296.e5. doi: 10.1016/j.jaapos.2022.09.005. Epub 2022 Oct 18.
Persistent fetal vasculature (PFV) is a congenital anomaly caused by failure of the ocular vasculature to regress. We report the visual and anatomic outcomes in patients who underwent surgery for PFV between 7-48 months of age.
The medical records of patients who underwent lensectomy and anterior or core vitrectomy for unilateral PFV, with or without intraocular lens implantation, were reviewed retrospectively. Inclusion criteria were surgery between 7-48 months of age and at least 12 months of follow-up. Patients with severe posterior segment involvement were excluded. The primary outcome was the final visual acuity using age-appropriate tests converted to logMAR. Secondary outcomes included the rate of adverse events and number of subsequent intraocular procedures.
A total of 20 patients with a mean age at surgery of 19.3 ± 10.5 months and mean follow-up of 73.7 ± 46.7 months were included. Sixteen patients had delayed surgery due to late presentation; the remaining 4 were managed initially with refractive correction and occlusion. Eight patients (40%) achieved a final visual acuity better than 1.0 logMAR. Four eyes had adverse events, including one retinal detachment. No patient developed glaucoma. Four eyes underwent subsequent procedures.
In our study cohort, surgery for unilateral PFV between 7-48 months of age achieved functional visual acuity in over one-third of patients. This is comparable to results achieved with surgery before 7 months of age, but with fewer adverse events. Differences in disease severity could account for later PFV presentation and surgery as well as outcomes.
永存原始玻璃体增生症（PFV）是一种由于眼部血管系统未能退化而导致的先天性异常。我们报告了年龄在7至48个月之间接受PFV手术的患者的视力和解剖学结果。
回顾性分析了因单侧PFV接受晶状体切除术和前部或核心玻璃体切除术（有或无人工晶状体植入）患者的病历。纳入标准为年龄在7至48个月之间且至少随访12个月。排除后段严重受累的患者。主要结局是使用转换为logMAR的适合年龄的测试得出的最终视力。次要结局包括不良事件发生率和后续眼内手术次数。
共纳入20例患者，手术时平均年龄为19.3±10.5个月，平均随访73.7±46.7个月。16例患者因就诊较晚而延迟手术；其余4例最初采用屈光矫正和遮盖治疗。8例患者（40%）最终视力优于1.0 logMAR。4只眼发生不良事件，包括1例视网膜脱离。无患者发生青光眼。4只眼接受了后续手术。
在我们的研究队列中，7至48个月龄的单侧PFV手术使超过三分之一的患者获得了功能性视力。这与7个月龄前手术的结果相当，但不良事件较少。疾病严重程度的差异可能解释了PFV就诊和手术较晚以及结局的情况。
