Tunica vasculosa lentis

小扁豆
  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    目的:评估大量早产儿视网膜病变(ROP)的发生率和危险因素。
    方法:单中心回顾性研究。包括2009年1月1日至2018年12月31日在卡塔尼亚Policlinico新生儿重症监护病房住院的所有早产儿。ROP阶段和位置,需要治疗,评估母婴危险因素.
    结果:对898例早产的病历进行了回顾性检查(平均胎龄32.9±2.3周)。其中149例(16.6%)发生了双侧ROP(92期1,44期2和13期3);66例(7.3%)接受了双侧激光治疗。受I区ROP1影响的三例患者的六只眼睛,在最佳激光治疗后持续15天,还接受了玻璃体内注射雷珠单抗。ROP发育的危险因素是胎龄(GA)(p<0.001),出生体重(p<0.001),辅助通气持续时间(p<0.001),多胎(p=0.003),促红细胞生成素(EPO)给药(p=0.005)和小扁豆膜的持久性。决策树分析表明,胎龄是最重要的预测因素(P<0.001);次要预测因素是29-31周GA新生儿的EPO给药(p=0.001)和32-34周GA出生体重低于2090g(p<0.001);在后一组中,动脉导管未闭(PDA)是第三预测因素(p=0.043)。
    结论:在我们的研究中,ROP发生率为16.6%;7.3%的患者需要激光治疗。除了众所周知的因素,例如GA和出生体重,其他因素,如辅助通气的持续时间,EPO,多胎,PDA,在调整眼科评估和随访时,应考虑细管膜的持久性。
    To evaluate Retinopathy of Prematurity (ROP) rate and risk factors in a large cohort of preterm newborns.
    Single center retrospective study. All preterm inborn hospitalized at the Neonatal Intensive Care Unit of the Policlinico of Catania from January 1, 2009 till December 31, 2018, were included. ROP stage and location, treatments required, maternal and infant risk factors were evaluated.
    Medical records of 898 preterms were retrospectively examined (mean gestational age 32.9 ± 2.3 weeks). Of them 149 (16.6 %) developed bilateral ROP (92 stage 1, 44 stage 2 and 13 stage 3); 66 (7.3 %) received bilateral laser treatment. Six eyes of three patients affected by zone I ROP 1, with plus persistence 15 days after an optimal laser treatment, also received intravitreal ranibizumab injection. Risk factors for ROP development were gestational age (GA) (p < 0.001), birthweight (p < 0.001), assisted ventilation duration (p < 0.001), multiple birth (p = 0.003), erythropoietin (EPO) administration (p = 0.005) and persistence of tunica vasculosa lentis. The decision-tree analysis showed gestational age as the most significant predictive factor (P < 0.001); secondary predictive factors were EPO administration (p = 0.001) in newborns 29-31 weeks GA and birthweight lower than 2090 g (p < 0.001) in 32-34 weeks GA; in this latter group patent ductus arteriosus (PDA) was a tertiary predictive factor (p = 0.043).
    In our study ROP incidence was 16,6 %; 7.3 % of the patients required laser treatment. Besides well-known factors, such as GA and birthweight, other factors like duration of assisted ventilation, EPO, multiple births, PDA, tunica vasculosa lentis persistence should be considered to tailor ophthalmic evaluation and follow-up.
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  • 文章类型: Case Reports
    This is a report of rare cases of full-term infants born with persistent tunica vasculosa lentis (TVL) with no retinopathy of prematurity (ROP) and no plus disease. This condition can be mistaken with iris vascular enlargement-associated plus disease, leading to unnecessary laser or intravitreal injections. The cases were treated with close observation, which resulted in complete resolution of the TVL. In conclusion, we encourage the diagnosis of TVL and careful monitoring of such cases before the intervention, as the condition may revert completely.
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  • 文章类型: Journal Article
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  • 文章类型: Case Reports
    背景:持续增生性原发性玻璃体(PHPV)是一种罕见的先天性发育性眼部疾病,由胚胎玻璃样脉管系统的不完全消退引起。在这里,我们报告了一例非手术的单侧前PHPV,该病例通过弱视治疗进行了治疗,并改善了视力和胎儿脉管系统的消退。
    方法:一名三岁女孩被诊断为左眼单侧前PHPV,表现为后极白内障,后囊混浊,小扁豆膜,和一条漂浮的玻璃样动脉连接到后牙肿块。斑块不够大,无法填满瞳孔,并进行保守治疗和弱视治疗。十九个月后,视力在受影响的眼睛从20/100提高到20/50矫正,胎儿血管逐渐消退,最后变成无灌注的幽灵血管。
    结论:在受PHPV影响的儿童中,可以观察到胎儿脉管系统的回归,保守治疗和弱视治疗可能有助于视力改善。
    BACKGROUND: Persistent hyperplastic primary vitreous (PHPV) is a rare congenital developmental ocular disorder caused by incomplete regression of the embryonic hyaloid vasculature. Here we report a case of nonsurgical unilateral anterior PHPV that was managed by amblyopia treatment and resulted in an improvement of visual acuity and regression of the fetal vasculature.
    METHODS: A three-year-old girl was diagnosed with unilateral anterior PHPV in the left eye, manifested with posterior pole cataract, posterior capsule opacification, tunica vasculosa lentis, and a floating hyaloid artery connected to the retrolental mass. The plaque was not large enough to fill the pupil, and conservative management along with amblyopia treatment was conducted. Nineteen months later, the visual acuity in the affected eye improved from 20/100 to 20/50 with correction, and the fetal vasculature regressed gradually and finally into a nonperfusion ghost vessel.
    CONCLUSIONS: In PHPV-affected children, regression of the fetal vasculature may be observed, and conservative management and amblyopia treatment may be helpful for visual improvement.
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  • 文章类型: Case Reports
    BACKGROUND: Laser therapy has been the gold standard treatment for retinopathy of prematurity (ROP), while intravitreal bevacizumab (IVB) is reported to be of significant benefit for zone I ROP. A problem with laser therapy is that it is difficult to administer in ROP patients with severely dilated tunica vasculosa lentis and poor mydriasis. However, although IVB treatment has been performed in such severe ROP cases, only 1 report has discussed its usefulness.
    UNASSIGNED: A male infant was born with a birth weight of 382 g at 23 weeks\' gestation. As visualization was poor and laser therapy could not be performed due to dilated tunica vasculosa lentis and poor mydriasis, IVB (0.625 mg/0.025 mL) was administered to both eyes. Following treatment, the ROP gradually improved, with regression of the dilated tunica vasculosa lentis and improvement of the mydriasis in both eyes.
    UNASSIGNED: A male infant was born with a birth weight of 698 g at 25 weeks\' gestation. As laser therapy could not be performed due to severely dilated tunica vasculosa lentis and poor mydriasis, IVB (0.625 mg/0.025 mL) was administered to both eyes. Following treatment, the ROP gradually improved, with regression of the dilated tunica vasculosa lentis and improvement of the mydriasis in both eyes.
    CONCLUSIONS: IVB is potentially more useful than laser therapy for the treatment of severe ROP with dilated tunica vasculosa lentis and poor mydriasis.
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  • 文章类型: Journal Article
    OBJECTIVE: Fibrillin-2 (Fbn2) is the dominant fibrillin isoform expressed during development of the mouse eye. To test its role in morphogenesis, we examined the ocular phenotype of Fbn2(-/-) mice.
    METHODS: Ocular morphology was assessed by confocal microscopy using antibodies against microfibril components.
    RESULTS: Fbn2(-/-) mice had a high incidence of anterior segment dysgenesis. The iris was the most commonly affected tissue. Complete iridal coloboma was present in 37% of eyes. Dyscoria, corectopia and pseudopolycoria were also common (43% combined incidence). In wild-type (WT) mice, fibrillin-2-rich microfibrils are prominent in the pupillary membrane (PM) during development. In Fbn2-null mice, the absence of Fbn2 was partially compensated for by increased expression of fibrillin-1, although the resulting PM microfibrils were disorganized, compared with WTs. In colobomatous adult Fbn2(-/-) eyes, the PM failed to regress normally, especially beneath the notched region of the iris. Segments of the ciliary body were hypoplastic, and zonular fibers, although relatively plentiful, were unevenly distributed around the lens equator. In regions where the zonular fibers were particularly disturbed, the synchronous differentiation of the underlying lens fiber cells was affected.
    CONCLUSIONS: Fbn2 has an indispensable role in ocular morphogenesis in mice. The high incidence of iris coloboma in Fbn2-null animals implies a previously unsuspected role in optic fissure closure. The observation that fiber cell differentiation was disturbed in Fbn2(-/-) mice raises the possibility that the attachment of zonular fibers to the lens surface may help specify the equatorial margin of the lens epithelium.
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