Posterior hyaloid contracture in pediatric vitreoretinopathies

Retinal detachment in pediatric vasoproliferative disorders such as retinopathy of prematurity (ROP) and familial exudative vitreoretinopathy (FEVR) have an exudative and tractional component. Younger eyes have an especially adherent posterior hyaloid. Contraction of the posterior hyaloid interface may lead to tractional retinal detachment.

Retrospective chart review of six eyes (four ROP, two FEVR) with diffuse contraction of the posterior hyaloid resulting in retinal detachment. Fundus photographs and optical coherence tomography findings (one eye) are presented.

Diffuse proliferation along the posterior hyaloid required extensive lamellar dissection at times aided by autologous plasmin enzyme. A diffuse, taut posterior hyaloid resulted in marked tractional component to retinal detachment.

Recognition of hyaloid contracture will aid in the proper diagnosis and surgical planning and repair of eyes with pediatric vasoproliferative disorders.