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Liu H, Peng J, Zhang W, Zhang X, Gu VY, Yang Y, Xiao H, Yin J, Jiao D, Tian T, Zhao P. ANATOMIC OUTCOMES OF LENS-SPARING VITRECTOMY FOR STAGE 3 OR 4 FAMILIAL EXUDATIVE VITREORETINOPATHY. Retina 2024; 44:1538-1545. [PMID: 39167575 PMCID: PMC11332369 DOI: 10.1097/iae.0000000000004147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
PURPOSE To report the anatomic outcomes and retinal structure changes from lens-sparing vitrectomy (LSV) for eyes with Stage 3 or 4 familial exudative vitreoretinopathy (FEVR). METHODS Overall, 133 consecutive eyes of 119 patients with Stage 3 (51 eyes) or 4 (82 eyes) FEVR who underwent LSV between January 2012 and May 2023 were retrospectively reviewed. RESULTS One hundred twenty-nine eyes (97.0%) achieved traction relief through one LSV operation. The extent of retinal detachment improved in 98 eyes (73.7%), remained stable in 32 eyes (24.1%), and progressed in three eyes (2.3%). At long-term follow-up, 39 (29.3%) and 60 (45.1%) eyes had completely or partially reattached retina, respectively. The median change of venular angle was 3.6° (95% CI, 3.5-10.5; P < 0.001) and -9.9° (95% CI, -15.8 to -4.6; P < 0.001) for temporal and nasal vessels, respectively. The mean disk-fovea distance was 0.3 papillary diameter shorter (95% CI, -0.4 to -0.2; P < 0.001), and the mean temporal venular arcade distance was 0.02 papillary diameter larger (95% CI, -0.16 to 0.21; P = 0.361). CONCLUSION These results suggest that LSV can relieve vitreoretinal traction and reattach the retina in late-stage FEVR eyes. Improvements in temporal and nasal venular angle and disk-fovea distance reflect positive retinal structure changes for patients.
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Affiliation(s)
- Huanyu Liu
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; and
| | - Jie Peng
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; and
| | - Wenting Zhang
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; and
| | - Xuerui Zhang
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; and
| | - Victoria Y. Gu
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Yuan Yang
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; and
| | - Haodong Xiao
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; and
| | - Jiawei Yin
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; and
| | - Dian Jiao
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; and
| | - Tian Tian
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; and
| | - Peiquan Zhao
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; and
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Zou Y, Peng J, Zhao P. Cyanoacrylate glue for iatrogenic retinal breaks during vitrectomy in stage 5 familial exudative vitreoretinopathy. Front Med (Lausanne) 2024; 11:1370394. [PMID: 38966537 PMCID: PMC11222635 DOI: 10.3389/fmed.2024.1370394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 06/10/2024] [Indexed: 07/06/2024] Open
Abstract
Purpose To describe the role of cyanoacrylate glue in sealing iatrogenic retinal breaks (IRBs) during vitrectomy in stage 5 familial exudative vitreoretinopathy (FEVR) with funneled retinal detachment (RD). Methods Nine eyes of nine patients diagnosed as stage 5 FEVR were treated with cyanoacrylate glue for IRBs during vitrectomy from July 2020 to January 2022. The clinical records, including patient information, surgical process, and follow-up examinations, were collected retrospectively. Anatomical outcomes and visual outcomes were summarized. Results The average age at surgery was 19.6 months (range: 3.8-41.1 months). The mean post-operative follow-up period was 12.5 months (range: 9.8-18.8 months). Before surgery, five eyes had an open-funnel RD and four eyes had a closed-funnel RD. All the preretinal fibroplasia membranes were removed as thoroughly as possible in the nine eyes. IRBs formed at the posterior pole in two eyes and peripheral retina in seven eyes. All the IRBs were sealed successfully by the cyanoacrylate glue when they appeared. At the final post-operative visit, eight eyes had partial retinal reattachment without progression of fibroplasia tissues, while one eye had total retinal redetachment. The rate for stable anatomical outcome was 88.9% (8/9) in this study. The visual testing available for seven eyes demonstrated light perception in five eyes and no light perception in two eyes. No severe perioperative glue-related complications were noted during the follow-ups. Conclusion The application of cyanoacrylate glue may be an alternative therapy for IRBs in stage 5 FEVR surgeries, while the long-term efficacy and safety still need further investigation.
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Affiliation(s)
| | - Jie Peng
- *Correspondence: Jie Peng, ; Peiquan Zhao,
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Chen C, Cheng Y, Zhang Z, Zhang X, Li J, Zhao P, Peng X. Long-term clinical prognosis of 335 infant single-gene positive FEVR cases. BMC Ophthalmol 2022; 22:329. [PMID: 35918671 PMCID: PMC9347171 DOI: 10.1186/s12886-022-02522-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 07/07/2022] [Indexed: 11/21/2022] Open
Abstract
Purpose To describe and analyze the clinical prognosis of infants diagnosed of familial exudative vitreoretinopathy (FEVR) with single gene mutation in long-term follow-up. Methods A retrospective case study was conducted on 355 FEVR infants with single positive gene. Result Of the 335 single-gene positive infant FEVR cases (under 3 years old), 20% (n = 67) was diagnosed of strabismus at first visit. Staging of various genotypes was different (P < 0.001). Patients with NDP mutations presented the most severe clinical phenotypes and patients with ZNF408 mutations presented the mildest clinical phenotypes. Most infants underwent surgery under 1 year old (5th stage 75 of 108 [69.44%]). The axial length of different genotypes showed no significant difference (P = 0.2891). The 1st to 3rd stage cases were given intravitreal injection and/or retina photocoagulation with the last follow-up vision above 20/67. The 4th to 5th stage cases received the transcorneal vitrectomy with lensectomy or lens sparing vitrectomy (LSV), whose lens maintained transparent after LSV (11/14[78.58%]). After 2 to 10 years of follow-up, 37.96% (41/108) of post-surgery cases showed retinal funnel-like unfold and posterior pole unfold, 69.57% (16/ 23) of which received second surgery for closure of pupil with good prognosis. At the last follow-up, 20% (60/300) were with vision above 20/200. Conclusion LRP5 gene mutation was the most common mutation in FEVR patients. The severity of the clinical phenotype varied with different gene mutations. The main surgical methods for cases at Stage 4–5 were transcorneal vitrectomy with lensectomy or LSV. The earlier FEVR occurred, the worse prognosis would be. Active surgical intervention and lens sparing were necessary for cases at Stage 4–5.
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Affiliation(s)
- Chunli Chen
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China.,Beijing Institute of Ophthalmology, Beijing, China
| | - Yizhe Cheng
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China
| | - Zhihan Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China
| | - Xiang Zhang
- Department of Ophthalmology, Xinhua Hospital, Medicine School of Shanghai Jiaotong University, No. 1665, Kongjiang Road, Shanghai, 200092, People's Republic of China
| | - Jiakai Li
- Department of Ophthalmology, Xinhua Hospital, Medicine School of Shanghai Jiaotong University, No. 1665, Kongjiang Road, Shanghai, 200092, People's Republic of China
| | - Peiquan Zhao
- Department of Ophthalmology, Xinhua Hospital, Medicine School of Shanghai Jiaotong University, No. 1665, Kongjiang Road, Shanghai, 200092, People's Republic of China.
| | - Xiaoyan Peng
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China. .,Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China. .,Beijing Ophthalmology and Visual Science Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No.1, Dongjiaominxiang Street, Dongcheng District, Beijing, 100005, People's Republic of China.
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Incidence and Risk Factors for Berger's Space Development after Uneventful Cataract Surgery: Evidence from Swept-Source Optical Coherence Tomography. J Clin Med 2022; 11:jcm11133580. [PMID: 35806863 PMCID: PMC9267354 DOI: 10.3390/jcm11133580] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/07/2022] [Accepted: 06/15/2022] [Indexed: 02/04/2023] Open
Abstract
Background: This study investigates the incidence and risk factors for the development of Berger’s space (BS) after uneventful phacoemulsification based on swept-source optical coherence tomography (SS-OCT). Methods: Cataractous eyes captured using qualified SS-OCT images before and after uneventful phacoemulsification cataract surgery were included. Six high-resolution cross-sectional anterior segment SS-OCT images at 30° intervals were used for BS data measurements. BS width was measured at three points on each scanned meridian line: the central point line aligned with the cornea vertex and two point lines at the pupil’s margins. Results: A total of 223 eyes that underwent uneventful cataract surgery were evaluated. Preoperatively, only two eyes (2/223, 0.9%) were observed to have consistent BS in all six scanning directions. BS was observed postoperatively in 44 eyes (44/223, 19.7%). A total of 13 eyes (13/223, 5.8%) with insufficient image quality, pupil dilation, or lack of preoperative image data were excluded from the study. A total of 31 postoperative eyes with BS and 31 matched eyes without BS were included in the final data analysis. The smallest postoperative BS width was in the upper quadrant of the vertical meridian line (90°), with a mean value of 280 μm. The largest BS width was observed in the opposite area of the main clear corneal incision, with a mean value >500 μm. Conclusions: Uneven-width BS is observable after uneventful phacoemulsification. Locations with a much wider BS (indirect manifestation of Wieger zonular detachment) are predominantly located in the opposite direction to the main corneal incisions.
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