The simplified technique using vitrectomy approach is safe and specific for targeting lens epithelial cells without associated complications.
Purpose: To report the clinical features and surgical outcomes of encircling scleral buckling surgery with cryotherapy in familial exudative vitreoretinopathy (FEVR) patients with rhegmatogenous RD.Methods: This study was a consecutive, retrospective interventional case series. Clinical features, including the FEVR stage, proliferative vitreoretinopathy grade, range of RD and degeneration, and presence of retinal breaks, and surgical outcomes, including the success rate, best-corrected visual acuity, and myopic shift, were analyzed.Results: There were 16 eyes with Stage 3A FEVR and eight eyes with Stage 4A FEVR. 13 eyes had Grade A proliferative vitreoretinopathy, and 11 eyes had Grade B proliferative vitreoretinopathy. Retinal reattachment was achieved in 22 of 24 eyes (91.67%) with FEVRrhegmatogenous RD after initial encircling scleral buckling surgery. The best-corrected visual acuity improved from a mean of 1.08 ± 0.86 logarithm of the minimum angle of resolution preoperatively to 0.45 ± 0.41 logarithm of the minimum angle of resolution postoperatively (P , 0.01). A myopic shift of 22.39 ± 1.38 (range, 21 to 26) diopter (P , 0.01) was observed. The mean follow-up period was 34.5 ± 27.7 (range, 7-104) months.Conclusion: Our study clarified the efficacy of encircling scleral buckling surgery with cryotherapy in FEVR-rhegmatogenous RD with Stage 3A or 4A FEVR and Grade A or B proliferative vitreoretinopathy, especially in patients with multiple retinal holes.RETINA 42:55-63, 2022F amilial exudative vitreoretinopathy (FEVR), a familial disorder characterized by incomplete retinal vascularization, was first described by Crisswick and Schepens in 1969. 1 Retinal detachment (RD) is a serious complication leading to visual disruption that occurs in 21% to 64% of eyes with FEVR. 2 In Eastern countries, FEVR-associated rhegmatogenous RD (FEVR-RRD) is more common than FEVRassociated tractional RD (TRD) or exudative RD. 3 The outcomes of the surgical treatment of FEVR-RRD have been reported, for which segmental scleral buckling (SSB) and vitrectomy with or without scleral buckling are extensively used, depending on the severity of the disease. 4-10 However, the indications for encircling scleral buckling (ESB) surgery have not been further discussed. Therefore, we retrospectively studied the clinical features and surgical outcomes of FEVR-RRD patients who underwent ESB surgery at our hospital. MethodsTwenty-four eyes with FEVR-RRD that underwent ESB surgery performed by experienced vitreoretinal 55
Background Pseudoduplication of the optic disc is a rare clinical condition that is characterized by a circumscribed, disc-like lesion with radiating vessels but only one normal optic nerve. We report a rare case that initially resembled a bifurcated optic nerve in a strabismus child. Case presentation A 6-year-old female child was initially referred to our hospital due to perceptual exotropia of 15 degrees with poor fixation of the left eye. The visual acuity of the left eye was 3/100 with a refraction of + 1.75/− 1.25 × 175. Fundus images of her left eye revealed a circumscribed and disc-like lesion located one disc diameter (DD) below the true optic disc that showed profound central cupping resembling a second optic disc with a vascular supply. B scan ultrasonography showed an optic nerve with a bifurcated weak-echo region, suggesting that two strands originated from the optic nerve. Optic coherence tomography (OCT) demonstrated a large crater-like depression of the lesion, indicating a colobomatous defect covered by a mysterious membranous structure, a disturbed nerve fibre layer and the absence of regular outer retinal layers. A perimetric examination revealed a relatively superior defect. Magnetic resonance imaging (MRI) revealed the left eye globe showed an abnormal morphology and that the optic nerve was abnormally shaped and shifted nasally in the left eye. Fundus fluorescein angiography (FFA) of the left eye revealed the absence of independent vascular vessels in the disc-like lesion. Hyperfluorescence with patchy fluorescence was evident in the inferotemporal area of the disc. Vascular loops surrounding the temporal region were evident in both eyes. Her right eye was normal except for the vascular loop. We proposed that this represented a case of pseudoduplication of the optic disc. The patient did not undergo any treatment, and her visual acuity remained stable during the follow-up period. Conclusions Our patient presented with a deep and ectatic coloboma below the optic disc that communicated with the true optic nerve and was originally thought to indicate a bifurcated optic nerve. This case suggests that atypical ectatic colobomas should be considered before diagnosing malformations related to the optic nerve in double optic disc cases.
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