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Tent-shaped retinal detachments in retinopathy of prematurity
Michael J Shapiro1, Joshua Alpert, Rahul T Pandit
1University of Illinois at Chicago, UIC Eye Center, IL 60612, USA. michshap@uic.edu
Insights
Tent-shaped retinal detachments are a unique finding in retinopathy of prematurity (ROP). Identifying and releasing the traction stalk during vitrectomy surgery often leads to successful retinal reattachment.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Neonatal Care
Background:
- Retinopathy of prematurity (ROP) commonly causes retinal detachments, typically radial, segmental, or circumferential.
- These detachments often feature cicatricial extraretinal fibrovascular proliferation (EFP) at their apex.
- This study focuses on unusual tent-shaped retinal detachments observed in ROP cases.
Purpose of the Study:
- To describe the characteristics of tent-shaped retinal detachments in retinopathy of prematurity.
- To evaluate the surgical outcomes for these specific detachments.
- To highlight the importance of identifying traction stalks in these cases.
Main Methods:
- An observational case series of 9 patients (13 eyes) with tent-shaped retinal detachments.
- Data collected included morphology, clinical details, surgical procedures, and final retinal status.
- Retrospective review of medical records.
Main Results:
- Diverse tent-shaped morphologies were observed, including simple, double, chevron-based, and star-shaped patterns.
- A consistent finding was a disk-based stalk extending to the detachment apex, often inserting into the retrolental space.
- Vitrectomy surgery in 11 eyes achieved retinal attachment in 9 eyes, indicating significant surgical success.
Conclusions:
- Tent-shaped retinal detachments are a distinct entity within ROP.
- Thorough evaluation for an associated traction stalk is crucial.
- Vitreous surgery targeting stalk release demonstrates a high success rate for retinal reattachment.
Background:
Most retinal detachments associated with retinopathy of prematurity (ROP) are radial, segmental, or circumferential with cicatricial extraretinal fibrovascular proliferation (EFP) at the apex of the detachment. This report describes peculiar tent-shaped retinal detachments that developed among eyes with ROP.
Methods:
An observational case series consisting of 9 patients and 13 eyes with tent-shaped retinal detachments. Their morphology, clinical baseline, surgical course, and final retinal status were extracted from medical records.
Results:
Eight had simple tent-shaped retinal detachments, three had a double tent-shaped retinal detachment, one had a chevron-based retinal detachment, and one had a star-shaped retinal detachment. Each case had a disk based stalk that extended to the apex of the traction retinal detachment and continued anteriorly; 12 stalks inserted in the retrolental space and 1 terminated in the mid vitreous. Six eyes were stage 4A, two eyes were stage 4B, and five eyes were stage 5. Vitrectomy surgery was performed on 11 eyes. Surgery resulted in retinal attachment in nine eyes, and two retinas remained detached.
Conclusion:
Tent-shaped retinal detachments are seen in patients with ROP. A stalk should be sought in evaluation of these eyes. Vitreous surgery focused on relieving this traction is often successful.
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