Early Diagnosis and Management of Aggressive Posterior Vitreoretinopathy Presenting in Premature Neonates

Ophthalmic Surg Lasers Imaging Retina. 2019 Apr 1;50(4):201-207. doi: 10.3928/23258160-20190401-01.

Abstract

Background and objective: Aggressive posterior vitreoretinopathy (APVR) manifests with a broad area of retinal avascularity, progressive neovascularization, and/or tractional retinal detachment during the neonatal period.

Patients and methods: A multicenter, retrospective, observational, consecutive case series study was performed to evaluate the retinal findings and structural retinal outcomes in patients treated for APVR within the first 3 months of life.

Results: Three premature neonates with a non-retinopathy of prematurity (ROP) APVR identified during routine ROP screening exams exhibited relatively severe, rapidly progressive retinal vascular abnormalities. Immediate laser photocoagulation of the avascular retina and vitrectomy for traction retinal detachment within several days to weeks improved or stabilized the retinal anatomy in all cases.

Conclusions: This series describes clinical features in APVR in premature infants and suggests that early diagnosis and intervention may mitigate the typical aggressive course and poor prognosis of this condition. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:201-207.].

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiogenesis Inhibitors / administration & dosage*
  • Disease Management
  • Early Diagnosis*
  • Female
  • Fluorescein Angiography / methods*
  • Fundus Oculi
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Intravitreal Injections
  • Laser Therapy / methods*
  • Male
  • Prognosis
  • Retrospective Studies
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity
  • Vitrectomy / methods*
  • Vitreoretinopathy, Proliferative / diagnosis*
  • Vitreoretinopathy, Proliferative / drug therapy
  • Vitreoretinopathy, Proliferative / surgery

Substances

  • Angiogenesis Inhibitors
  • Vascular Endothelial Growth Factor A