Vitrectomy for proliferative retinopathy in patient with advanced duchenne muscular dystrophy

Retinal vascular abnormalities are rare in patients with Duchenne muscular dystrophy. We present a patient with Duchenne muscular dystrophy who developed severe proliferative retinopathy for which vitrectomy was successfully performed in one eye.

Case presentation. A 23-year-old Japanese man with Duchenne muscular dystrophy complicated by cardiac and respiratory insufficiency had reduced vision in both eyes. His best-corrected visual acuity was 0.01 in the right eye and hand movements in the left eye. Ophthalmoscopy showed vitreous hemorrhage and proliferative tissue attached to the optic disk bilaterally. Ultrasound echography showed tractional retinal detachment in the left eye.

Because general anesthesia was considered to be a high risk, vitrectomy, lensectomy, neovascular membrane removal, endolaser photocoagulation, and silicone oil injection were performed under local anesthesia on the right eye. After removal of the silicone oil and intraocular lens implantation, the best-corrected visual acuity was 0.8 in the right eye. Vitrectomy was performed on the left eye, but the retina could not be attached.

The etiology of the proliferative retinopathy in our case is not known. Because early treatment has the potential to improve and maintain vision, we recommend periodic fundus examinations in patients with Duchenne muscular dystrophy.