Abstract：
OBJECTIVE: This study aims to investigate surgical outcomes of eyes with severe anterior persistent fetal vasculature (PFV) and the role of associated anatomical anomalies on prognosis.
METHODS: This is a retrospective, comparative case series of 32 eyes of 31 patients who underwent vitreoretinal surgery for severe anterior PFV, defined as fibrovascular tissue totally covering the back of cataractous lens. Based on the degree of anterior retinal elongations, cases were classified as follows: group 1, eyes with well-developed pars plana and minor/no abnormalities (n = 11, 34%); group 2, eyes with partially developed pars plana and broad-based elongations (n = 9, 28%); and group 3, eyes with no visible pars plana and fibrovascular membrane having 360° continuity with peripheral retina (n = 12, 38%). Complications and functional and anatomical outcomes were investigated.
RESULTS: The median surgical age was 2 (1-12) months. The median follow-up was 26 (6-120) months. Seventy-three percent in group 1 achieved finger counting or better vision with a single surgery and without any pupillary/retinal complication. Groups 2 and 3 required 2.1 ± 0.9 and 2.6 ± 1.2 surgeries on average. Pupillary obliteration and RD occurred in 33% and 22% in group 2 and 58% and 67% in group 3. Retina remained attached after silicone oil removal in 89% of group 2 and 25% of group 3. Phthisis developed in 50% in group 3.
CONCLUSIONS: Peripheral retinal anomalies are common in severe anterior PFV and have a major impact on prognosis. Prognosis is favorable in cases with mild-to-moderate anomalies with appropriate management of possible retinal tears. In eyes with 360° retinal elongations, severe fibrous proliferation and eventual eye loss are common.
METHODS: This is a retrospective, comparative case series of 32 eyes of 31 patients who underwent vitreoretinal surgery for severe anterior PFV, defined as fibrovascular tissue totally covering the back of cataractous lens. Based on the degree of anterior retinal elongations, cases were classified as follows: group 1, eyes with well-developed pars plana and minor/no abnormalities (n = 11, 34%); group 2, eyes with partially developed pars plana and broad-based elongations (n = 9, 28%); and group 3, eyes with no visible pars plana and fibrovascular membrane having 360° continuity with peripheral retina (n = 12, 38%). Complications and functional and anatomical outcomes were investigated.
RESULTS: The median surgical age was 2 (1-12) months. The median follow-up was 26 (6-120) months. Seventy-three percent in group 1 achieved finger counting or better vision with a single surgery and without any pupillary/retinal complication. Groups 2 and 3 required 2.1 ± 0.9 and 2.6 ± 1.2 surgeries on average. Pupillary obliteration and RD occurred in 33% and 22% in group 2 and 58% and 67% in group 3. Retina remained attached after silicone oil removal in 89% of group 2 and 25% of group 3. Phthisis developed in 50% in group 3.
CONCLUSIONS: Peripheral retinal anomalies are common in severe anterior PFV and have a major impact on prognosis. Prognosis is favorable in cases with mild-to-moderate anomalies with appropriate management of possible retinal tears. In eyes with 360° retinal elongations, severe fibrous proliferation and eventual eye loss are common.
摘要：
目的：本研究旨在探讨重度前持续性胎儿血管（PFV）眼的手术结局以及相关解剖异常对预后的影响。
方法：这是一个回顾性研究，31例接受玻璃体视网膜手术治疗的重度前PFV患者的32只眼的比较病例系列，定义为完全覆盖白内障晶状体背面的纤维血管组织。根据视网膜前伸长的程度,病例分类如下：第1组，平坦部发育良好且轻度/无异常的眼睛（n=11，34％）；第2组，平坦部部分发育且宽基伸长的眼睛（n=9，28％）；第3组，无可见平坦部和纤维血管膜的眼睛与周边视网膜有360°连续性（n=12，38％）。对并发症以及功能和解剖学结果进行了调查。
结果：中位手术年龄为2（1-12）个月。中位随访时间为26(6-120)个月。第一组中有73％的人通过一次手术获得了手指计数或更好的视力，并且没有任何瞳孔/视网膜并发症。第2组和第3组平均需要2.1±0.9和2.6±1.2手术。第2组分别为33%和22%，第3组分别为58%和67%。除去硅油后，第2组的89％和第3组的25％的视网膜仍保持附着。在第3组中，Phthisis发展为50％。
结论：周边视网膜异常常见于严重的前PFV，对预后有重要影响。在轻度至中度异常并适当处理可能的视网膜撕裂的情况下，预后良好。在具有360°视网膜伸长的眼睛中，严重的纤维增生和最终的眼睛损失是常见的。
方法：这是一个回顾性研究，31例接受玻璃体视网膜手术治疗的重度前PFV患者的32只眼的比较病例系列，定义为完全覆盖白内障晶状体背面的纤维血管组织。根据视网膜前伸长的程度,病例分类如下：第1组，平坦部发育良好且轻度/无异常的眼睛（n=11，34％）；第2组，平坦部部分发育且宽基伸长的眼睛（n=9，28％）；第3组，无可见平坦部和纤维血管膜的眼睛与周边视网膜有360°连续性（n=12，38％）。对并发症以及功能和解剖学结果进行了调查。
结果：中位手术年龄为2（1-12）个月。中位随访时间为26(6-120)个月。第一组中有73％的人通过一次手术获得了手指计数或更好的视力，并且没有任何瞳孔/视网膜并发症。第2组和第3组平均需要2.1±0.9和2.6±1.2手术。第2组分别为33%和22%，第3组分别为58%和67%。除去硅油后，第2组的89％和第3组的25％的视网膜仍保持附着。在第3组中，Phthisis发展为50％。
结论：周边视网膜异常常见于严重的前PFV，对预后有重要影响。在轻度至中度异常并适当处理可能的视网膜撕裂的情况下，预后良好。在具有360°视网膜伸长的眼睛中，严重的纤维增生和最终的眼睛损失是常见的。
