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Published on: November 14, 2012
Visual prognosis of posterior and combined persistent fetal vasculature
Veronique Promelle1,2, Sophie Bryselbout1, Solange Milazzo1,2
1Ophthalmology Department, Amiens Picardie University Hospital Center, Amiens, France.
Insights
Persistent fetal vasculature (PFV) posterior and combined forms have poor visual outcomes. Surgery may be needed for severe cases to achieve results comparable to patching for moderate PFV.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Congenital Eye Anomalies
Background:
- Persistent fetal vasculature (PFV) involves congenital anomalies from abnormal hyaloid vascular system persistence.
- PFV can manifest as anterior, posterior, or combined forms, impacting visual development.
- Understanding visual outcomes in posterior and combined PFV is crucial for timely intervention.
Purpose of the Study:
- To evaluate and report the visual outcomes for patients with posterior and combined forms of persistent fetal vasculature.
- To compare the effectiveness of different treatment modalities on visual acuity in PFV patients.
Main Methods:
- A retrospective, single-center study analyzed patients with posterior or combined PFV.
- Visual acuity was the primary endpoint, assessed at the study's conclusion.
- Data included patient demographics, PFV form, and treatment received (surgery, patching, or none).
Main Results:
- 18 eyes from 14 patients (10 male) were included; 12/18 had the combined form, and 4/14 had bilateral PFV.
- Visual acuity ranged from 20/2000 to 20/25.
- Surgical intervention (cataract extraction, phacovitrectomy) yielded a best visual acuity of 20/63, while patching for amblyopia resulted in 20/100. One untreated patient achieved 20/25.
Conclusions:
- Posterior and combined PFV forms are associated with a generally poor visual prognosis.
- Severe or occulting PFV presentations necessitate surgical intervention for optimal visual outcomes.
- Surgical results can be comparable to those achieved with patching therapy in moderate PFV cases.
Introduction:
The persistent fetal vasculature refers to congenital anomalies of the globe resulting from the abnormal persistence of the hyaloid vascular system. It can present as anterior, posterior, or combined form. The aim of this study was to report the visual outcomes of posterior and combined forms of persistent fetal vasculature.
Methods:
This retrospective, single-center study included every patient referred to our outpatient clinic with a posterior or combined form of persistent fetal vasculature. The primary endpoint was the visual acuity of the impaired eye, or of the best eye if bilateral, at the end of follow-up.
Results:
In total, 18 eyes of 14 patients (10 males) were included. The combined form was the most prevalent (12 of 18 eyes), and 4 of 14 patients had bilateral impairment. The range of assessed visual acuity was from 20/2000 to 20/25. The best visual acuity in patients having undergone a surgical procedure was 20/63 (cataract extraction = 3, combined phacovitrectomy = 1). In patients who had been treated for amblyopia with patching, without surgery, the best visual acuity measured was 20/100 (5 patients). Among patients who had neither surgery nor patching therapy, there was one 63-year-old patient with a 20/25 visual acuity; the other ones had a low visual acuity of less than 20/200. All included eyes presented with nystagmus, amblyopia, and/or strabismus at the end of follow-up.
Conclusion:
The posterior and combined forms of persistent fetal vasculature are of poor visual prognosis. The severe or occulting presentations require surgery to obtain the same visual outcomes as the moderate forms treated for amblyopia with patching therapy.
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