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Retrolental fibroplasia: I. Clinical observations
Insights
Proliferative retrolental fibroplasia in premature infants involves arteriovenous shunts and microvascular changes. Regression and scarring involve specific vascular and retinal alterations.
Area of Science:
- Ophthalmology
- Neonatology
- Vascular Biology
Background:
- Retrolental fibroplasia (RLF) is a significant cause of blindness in premature infants.
- Understanding the vascular changes in RLF is crucial for timely intervention.
Purpose of the Study:
- To characterize the vascular lesions in proliferative retrolental fibroplasia.
- To describe the mechanisms of regression and cicatrization in RLF.
Main Methods:
- Fundus photography and fluorescein angiography were utilized.
- 97 premature infants with RLF were included in the study.
Main Results:
- Proliferative RLF was identified as a macrovascular arteriovenous shunt.
- Microvascular abnormalities included capillary tufts, collaterals, capillary-free zones, and neovascular membranes.
- Regression involved capillary ingrowth into avascular areas, while cicatrization showed persistent vascular changes and scar formation.
Conclusions:
- Arteriovenous shunts are key macrovascular lesions in proliferative RLF.
- Distinct microvascular changes and patterns of regression/cicatrization were identified.
Abstract:
The changes occurring in retrolental fibroplasia were studied in 97 premature infants with fundus photography and fluorescein angiography. The macrovascular lesion of proliferative retrolental fibroplasia was identified as a functioning arteriovenous shunt. The microvascular abnormalities were capillary tufts, collaterals, capillary-free zones, and neovascular membranes. Regression was signaled by the ingrowth of capillaries from the shunt into the avascular retina. Cicatrization was characterized by persistence of the vascular abnormalities of the proliferative phase and organization of the avascular retina into a contracting scar.