Long-term Visual and Anatomic Outcomes Following Late Surgery for Unilateral Persistent Fetal Vasculature: A Single-Center, 22-Year Review
Authors: Bashar M. Bata1, Sina Khalili2, Asim Ali2, Michael M. Wan2, Kamiar Mireskandari2.
1Dalhousie University, 2The Hospital for Sick Children.
Author Disclosure Block: B.M. Bata: None. S. Khalili: None. A. Ali: Any direct financial payments including receipt of honoraria; Name of for-profit or not-for-profit organization(s); Santen. Any direct financial payments including receipt of honoraria; Description of relationship(s); Consulting Fees. Funded grants or clinical trials; Name of for-profit or not-for-profit organization(s); Novartis. Funded grants or clinical trials; Description of relationship(s); Grant. M.M. Wan: None. K. Mireskandari: None.
Title: Long-term Visual and Anatomic Outcomes Following Late Surgery for Unilateral Persistent Fetal Vasculature: A Single-Center, 22-Year Review
Purpose: Persistent fetal vasculature (PFV) is a congenital anomaly caused by complete or partial failure of the ocular fetal vasculature to regress. We report the visual and anatomic outcomes in a cohort of patients who underwent late surgery for PFV.
Study Design: A retrospective review of patients who underwent lensectomy and anterior or core vitrectomy for unilateral PFV, with or without intraocular lens implantation, was performed.
Methods: Inclusion criteria were those operated on after 7 months of age with at least 12 months of follow-up. Patients with severe posterior segment involvement were excluded. The primary outcome was the final visual acuity (VA) using age-appropriate tests converted to logMAR. Secondary outcomes included the rate of adverse events and the number of subsequent intraocular procedures.
Results: Twenty patients met the inclusion criteria. Mean age at surgery was 19.3 ± 10.5 months with a mean follow-up of 73.7 ± 46.7 months. Sixteen patients had delayed surgery due to late presentation, whereas the remaining four were managed initially with refractive correction and occlusion. Primary intraocular lens implantation was done in ten patients (50%), who had a mean age of 26.4 ± 9.6 months. The remaining ten patients had a mean age of 12.2 ± 5.3 months. Eight patients (40%) achieved a final VA better than 1.0 logMAR. Ten patients had navigational vision equal or worse than 1.0 logMAR. Of the remaining 2 patients, one achieved perception of light and one no perception of light. Four eyes developed adverse events including one event of retinal detachment. None developed glaucoma. Four eyes underwent subsequent procedures, two of which were secondary IOL implantation.
Conclusions: In our study cohort, late surgery for unilateral PFV achieved functional visual acuity in over a third of patients. This is comparable to the results achieved with early surgery but with less adverse events.