Anatomic and Visual Outcomes Following Surgery for Persistent Fetal Vasculature: A 20-year Retrospective Review
Bashar M. Bata; Kamiar Mireskandari; Asim Ali; Wai-Ching Lam; Hannah H. Chiu; Michael J. Wan
The Hospital for Sick Children
Introduction: Persistent fetal vasculature (PFV) can be anterior, posterior or combined. We report the visual and anatomic outcomes in patients who underwent surgery for PFV.
Methods: We retrospectively reviewed medical records of patients over a 20-year period who had undergone surgery for PFV without IOL implantation, prior to 7 months of age. Patients without other ocular comorbidities and whom had follow-up of more than 12 months were included.
Results: Seventy eyes of 67 patients were included. Sixty-one eyes (87.1%) had anterior PFV, 1 (1.4%) had posterior PFV and 8 (11.4%) had combined PFV. Twenty-seven eyes were microphthalmic, 4 (5.7%) had a retinal fold and 6 (8.6%) had retinal detachment at the time of surgery. The mean age at surgery was 2.0 months (range 0.2-6.3 months) and the mean follow-up was 88.9 months. At final follow-up, 24 eyes (34.3%) had visual acuity better than 1.0 LogMAR, 22 of which had anterior PFV (P=0.15), and 12 eyes (17.1%) had acuity better than 0.7 LogMAR, all of which had anterior PFV (P=0.34). Thirty-nine eyes (55.7%) had an adverse event; glaucoma in 22 (31.4%), retinal detachment in 10 (14.2%) and phthisis in 9 (12.9%). Of these 39 eyes, 35 had anterior PFV (P=0.5) and 14 had pars plicata incisions (P=0.97).
Discussion: Despite broader inclusion criteria, the rate of adverse events in our study matches that of PFV eyes in the contact lens group of the Infant Aphakia Treatment Study.1
Conclusion: Despite the high rate of adverse events, many eyes with PFV achieve functional vision.
References: 1Morrison DG, Wilson ME, Trivedi RH, Lambert SR, Lynn MJ. Infant Aphakia Treatment Study: effects of persistent fetal vasculature on outcome at 1 year of age. Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus. 2011;15(5):427-431.