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Touzé R, Abitbol MM, Bremond-Gignac D, Robert MP. RETINAL VASCULAR ABNORMALITIES IN CHILDREN WITH NEUROFIBROMATOSIS TYPE 1. Retina 2021; 41:2589-2595. [PMID: 34111884 DOI: 10.1097/iae.0000000000003234] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE Retinal vascular abnormalities (RVAs) have been recently described in patients with neurofibromatosis Type 1 (NF1) as vascular tortuosity, best visible on infrared imaging. This study assessed clinical RVA's characteristics in a large series of children with NF1. METHODS This retrospective observational study was conducted in children (0-18 years) with an NF1 diagnosis. Using near-infrared imaging, RVAs were classified according to the nature of vessels involvement and their degree of tortuosity. RESULTS Retinal imaging from 140 children, with a median age of 8.8 years (1.5-18), was included; 52 patients (37.1%) (81 eyes) exhibited RVAs. These RVAs comprised 96% (50/52) of simple vascular tortuosity and 17% (9/52) of a corkscrew pattern. A corkscrew pattern involved only small veins, whereas simple vascular tortuosity could affect both arteries and veins. No statistically significant age correlation was observed, but evolution of RVAs from simple vascular tortuosity to corkscrew pattern was observed in 5 cases. CONCLUSION Retinal vascular abnormalities occurred in 37.1% of children with NF1. These abnormalities may result from NF1 promoting localized tortuosity in both small arteries and veins, whereas only small second-order or tertiary-order venules evolve to a highly tortuous pattern.
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Affiliation(s)
- Romain Touzé
- Ophthalmology Department, Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Marc M Abitbol
- Ophthalmology Department, Hôpital Universitaire Necker-Enfants Malades, Paris, France
- INSERM, UMRS 1138, Team 17, from Physiopathology of Ocular Diseases to Clinical Development, Paris University, Paris, France; and
| | - Dominique Bremond-Gignac
- Ophthalmology Department, Hôpital Universitaire Necker-Enfants Malades, Paris, France
- INSERM, UMRS 1138, Team 17, from Physiopathology of Ocular Diseases to Clinical Development, Paris University, Paris, France; and
| | - Matthieu P Robert
- Ophthalmology Department, Hôpital Universitaire Necker-Enfants Malades, Paris, France
- Borelli Centre, UMR 9010, CNRS-SSA-ENS Paris Saclay-Paris University, Paris, France
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Hua HU, Martens R, Read SP, Cernichiaro-Espinosa LA, Fallas B, Oliver AL, Younis R, Rodriguez L, Berrocal AM. Neurofibromatosis type 1 presenting with retinal detachment and laryngeal plexiform neurofibroma in a toddler. Am J Ophthalmol Case Rep 2021; 23:101170. [PMID: 34381922 PMCID: PMC8332657 DOI: 10.1016/j.ajoc.2021.101170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 04/10/2021] [Accepted: 07/19/2021] [Indexed: 12/03/2022] Open
Abstract
Purpose To present a 22-month-old girl with a complete retinal detachment who was found to have systemic exam findings consistent with neurofibromatosis type 1 during the course of multi-specialty exam under anesthesia. Observations During examination under anesthesia, ophthalmic exam findings demonstrated retinal detachment with cyst formation, as well as peripheral non-perfusion of the retina in the left eye. Non-ophthalmic findings discovered on difficulty with intubation included a laryngeal plexiform neurofibroma and café-au-lait spots. Conclusions Pediatric retinal detachments are uncommon compared to those in adults. Pediatric patients with neurofibromatosis type 1 can present with vision loss as the presenting symptom. Systemic signs and symptoms should be carefully screen and monitored.
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Affiliation(s)
- Hong-Uyen Hua
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, 900 NW 17th St Miami, FL, 33136, USA
| | - Rosanna Martens
- Department of Ophthalmology and Visual Sciences, University of British Columbia, 2550 Willow Street, Vancouver, BC, V5Z 3N9, Canada
| | - Sarah Parker Read
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, 900 NW 17th St Miami, FL, 33136, USA
| | - Linda A Cernichiaro-Espinosa
- Asociación Para Evitar La Ceguera en México, IAP, Vicente García Torres 46, Colonia Barrio San Lucas, Coyoacán, Ciudad de México, C.P 04030, Mexico
| | - Brenda Fallas
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, 900 NW 17th St Miami, FL, 33136, USA
| | - Armando L Oliver
- Department of Ophthalmology, University of Puerto Rico, Medical Sciences Campus, PO BOX 365067, San Juan, 00936-5067, Puerto Rico
| | - Ramzi Younis
- Bascom Palmer Eye Institute, Department of Otolaryngology, University of Miami Miller School of Medicine, 900 NW 17th St, Miami, FL, 33136, USA
| | - Luis Rodriguez
- Department of Anesthesiology, University of Miami Miller School of Medicine, 1611 NW 12th Ave (C-301), Miami, FL, 33136, USA
| | - Audina M Berrocal
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, 900 NW 17th St Miami, FL, 33136, USA
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Retinal manifestations of the neurocutaneous disorders. Curr Opin Ophthalmol 2020; 31:549-562. [PMID: 33009088 DOI: 10.1097/icu.0000000000000712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE OF REVIEW The neurocutaneous disorders are a genetically and phenotypically diverse group of congenital syndromes characterized by cutaneous, ocular, and central nervous system manifestations. This review provides an overview of the clinical features and retinal findings in selected neurocutaneous disorders. RECENT FINDINGS Advances in genetics and diagnostic retinal and neuroimaging allow for the recognition of retinal features of common neurocutaneous syndromes and for improved characterization of rarer entities based on previously underdiagnosed or unrecognized retinal findings. SUMMARY Better characterization of the neurocutaneous disorders allows for earlier recognition and the potential for expeditious vision-saving and life-saving treatment.
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