Diagnostic sensitivity and specificity of color Doppler flow imaging for persistent hyperplastic primary vitreous_Chinese Journal of Ocular Fundus Diseases

Authors：

ChenWei , LiDongjun , WangZiyang , ZhaoQi , LiYifeng , CuiRui , ShenLin ,  YangWenli

Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China;

Corresponding author：

YangWenli, Email: yangwl_tr@163.com

Keywords：

Persistent hyperplastic primary vitreous/diagnosis; Ultrasonography, doppler, color

DOI：

10.3760/cma.j.issn.1005-1015.2016.03.016

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Objective To observe the diagnostic sensitivity and specificity of color Doppler flow imaging (CDFI) for persistent hyperplastic primary vitreous (PHPV). Methods The clinical data of 71 children (93 eyes) with congenital cataract which suspected of concurrent PHPV were retrospectively analyzed. The children included 45 males (54 eyes) and 26 females (39 eyes), aged from 1 to 24 months, with an average age of (7.6±4.3) months. All eyes were examined by CDFI, and observe whether there was a pathological strip in the vitreous, the site of the connection between the strip echo and the wall of the eye and the signal of blood flow on the strip echo. Within 1 week after a CDFI examination under general anesthesia, 64 children (79 eyes) underwent lens excision combined with vitrectomy and the other 14 eyes of 7 children underwent mydriatic fundus examination by two experienced eye specialists. Combined with clinical features of PHPV, the diagnosis and differential diagnosis were made according to the clouding of the lens, posterior capsule proliferation, vitreous proliferation and retinal detachment position which were found during operation and fundus examination. Compare and analyze the CDFI examination results and the above diagnosis results, calculate the sensitivity and specificity of CDFI for PHPV. Results In surgery and mydriatic fundus examination results of 93 eyes, vitreous abnormal in 85 eyes, no significant changes were found in vitreous of the other 8 eyes. In 85 eyes of abnormal vitreous, 68 eyes were diagnosed as PHPV, 16 eyes were diagnosed as familial exudative vitreoretinopathy (FEVR), and 1 eye was diagnosed as treactional retinal detachment. In 85 eyes of abnormal vitreous which were found by surgery and fundus examination, CDFI confirmed 81 eyes and its diagnostic sensitivity was 95.3%; the other 4 eyes were not found vitreous abnormality, and the missed diagnosis rate was 4.7%. Surgery and mydriatic fundus examination found no vitreous abnormal in 8 eyes, but CDFI explored strip low echo connected with the optic disc or posterior lens capsule in vitreous. In the 68 eyes of PHPV which were diagnosed by surgery or fundus examination, 59 eyes had the same diagnosis of CDFI, the sensitivity of CDFI was 86.8%; PHPV was not diagnosed in 25 eyes by surgery or fundus examination, but only 8 eyes were also not diagnosed by CDFI, and the specificity of CDFI was 32.0%. The remaining 17 eyes were diagnosed as FEVR in 16 eyes and traction retinal detachment in 1 eye after surgery or mydriatic fundus examination, but they were all diagnosed as PHPV in CDFI. The misdiagnosis rate of CDFI was 68.0%. Conclusion For PHPV, the diagnostic sensitivity and specificity of CDFI are 86.8% and 32.0%, respectively.

Citation： ChenWei, LiDongjun, WangZiyang, ZhaoQi, LiYifeng, CuiRui, ShenLin, YangWenli. Diagnostic sensitivity and specificity of color Doppler flow imaging for persistent hyperplastic primary vitreous. Chinese Journal of Ocular Fundus Diseases, 2016, 32(3): 296-299. doi: 10.3760/cma.j.issn.1005-1015.2016.03.016 Copy

1.	Jensen OA. Persistent hyperplastic primary vitreous. Cases in Denmark 1942-1966. A mainly histopathological study[J].Acta Ophthalmol, 1968, 46(3):418-429.
2.	Hunt A, Rowe N, Lam A, et al. Outcomes in persistent hyperplastic primary vitreous[J].Br J Ophthalmol, 2005, 89(7):859-863.
3.	杨文利, 魏文斌, 翁乃清, 等.复杂玻璃体视网膜疾病的彩色多普勒超声诊断特征[J].中华眼科杂志, 2005, 4(3):226-230. DOI:10.3760/j.issn.0412-4081.2005.03.008.Yang WL, Wei WB, Weng NQ, et al. Color Doppler flow imaging in the diagnosis of complex vitreoretinal diseases[J].Chin J Ophthalmol, 2005, 4(3):226-230. DOI:10.3760/j.issn.0412-4081.2005.03.008.
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6.	James DR, Scott EO. Pediatric Retina[M]. New York:Springer-Verlag Berlin Heidelberg, 2011:191-204.
7.	Kaste SC, Jenkins JJ 3rd, Meyer D, et al. Persistent hyperplastic primary vitreous of the eye:imaging findings with pathologic correlation[J]. Am J Roentgenol, 1994, 162(2):437-440.
8.	Pollard ZF. Persistent hyperplastic primary vitreous:diagnosis, treatment and results[J]. Trans Am Ophthalmol Soc, 1997, 95:487-549.
9.	Hunt A, Rowe N, Lam A, et al. Outcomes in persistent hyperplastic primary vitreous[J]. Br J Ophthalmol, 2005, 89(7):859-863.
10.	朱瑜洁, 赵培泉, 张琦. 129例永存原始玻璃体增生症的临床特征和术后疗效分析[J].上海交通大学学报(医学版), 2013, 3(6):846-850. DOI:10.3969/j.issn.1674-8115.2013.06.030.Zhu YJ, Zhao PQ, Zhang Q.Clinical characteristics and surgical outcomes of 129 cases of persistent hyperplastic primary vitreous[J]. Journal of Shanghai Jiaotong University (Medical Science), 2013, 3(6):846-850. DOI:10.3969/j.issn.1674-8115.2013.06.030.
11.	Sinha R, Bali SJ, Kumar C, et al. Results of cataract surgery and plasma ablation posterior capsulotomy in anterior persistent hyperplastic primary vitreous[J]. Middle East Afr J Ophthalmol, 2013, 20(3):217-220. DOI:10.4103/0974-9233.114794.
12.	胡毅倩, 周秀莉, 余文晶, 等. 60例FEVR患眼B型超声图像分析[J].中国超声医学杂志, 2015, 31(6):481-482.Hu YQ, Zhou XL, Yu WJ, et al. Ultrasonography findings in 60 cases of familial exudative vitreoretinopathy[J].Chinese J Ultrasound Med, 2015, 31(6):481-482.

1. Jensen OA. Persistent hyperplastic primary vitreous. Cases in Denmark 1942-1966. A mainly histopathological study[J].Acta Ophthalmol, 1968, 46(3):418-429.
2. Hunt A, Rowe N, Lam A, et al. Outcomes in persistent hyperplastic primary vitreous[J].Br J Ophthalmol, 2005, 89(7):859-863.
3. 杨文利, 魏文斌, 翁乃清, 等.复杂玻璃体视网膜疾病的彩色多普勒超声诊断特征[J].中华眼科杂志, 2005, 4(3):226-230. DOI:10.3760/j.issn.0412-4081.2005.03.008.Yang WL, Wei WB, Weng NQ, et al. Color Doppler flow imaging in the diagnosis of complex vitreoretinal diseases[J].Chin J Ophthalmol, 2005, 4(3):226-230. DOI:10.3760/j.issn.0412-4081.2005.03.008.
4. 李栋军, 陈伟, 王子杨, 等.眼外伤所致眼内病理膜的彩色多普勒超声诊断特点[J].中华眼视光学与视觉科学杂志, 2014, 16(11):655-658. DOI:10.3760/cma.j.issn.1674-845X.2014.11.004.Li DJ, Chen W, Wang ZY, et al. Color Doppler flow imaging for the diagnosis of damage to intraocular membranes from ocular trauma[J].Chin J Ophthalmol Vis Sci, 2014, 16(11):655-658. DOI:10.3760/cma.j.issn.1674-845X.2014.11.004.
5. Galhotra R, Gupta K, Kaur S, et al. Bilateral persistent hyperplastic primary vitreous:a rare entity[J]. Oman J Ophthalmol, 2012, 5(1):58-60. DOI:10.4103/0974-620X.94780.
6. James DR, Scott EO. Pediatric Retina[M]. New York:Springer-Verlag Berlin Heidelberg, 2011:191-204.
7. Kaste SC, Jenkins JJ 3rd, Meyer D, et al. Persistent hyperplastic primary vitreous of the eye:imaging findings with pathologic correlation[J]. Am J Roentgenol, 1994, 162(2):437-440.
8. Pollard ZF. Persistent hyperplastic primary vitreous:diagnosis, treatment and results[J]. Trans Am Ophthalmol Soc, 1997, 95:487-549.
9. Hunt A, Rowe N, Lam A, et al. Outcomes in persistent hyperplastic primary vitreous[J]. Br J Ophthalmol, 2005, 89(7):859-863.
10. 朱瑜洁, 赵培泉, 张琦. 129例永存原始玻璃体增生症的临床特征和术后疗效分析[J].上海交通大学学报(医学版), 2013, 3(6):846-850. DOI:10.3969/j.issn.1674-8115.2013.06.030.Zhu YJ, Zhao PQ, Zhang Q.Clinical characteristics and surgical outcomes of 129 cases of persistent hyperplastic primary vitreous[J]. Journal of Shanghai Jiaotong University (Medical Science), 2013, 3(6):846-850. DOI:10.3969/j.issn.1674-8115.2013.06.030.
11. Sinha R, Bali SJ, Kumar C, et al. Results of cataract surgery and plasma ablation posterior capsulotomy in anterior persistent hyperplastic primary vitreous[J]. Middle East Afr J Ophthalmol, 2013, 20(3):217-220. DOI:10.4103/0974-9233.114794.
12. 胡毅倩, 周秀莉, 余文晶, 等. 60例FEVR患眼B型超声图像分析[J].中国超声医学杂志, 2015, 31(6):481-482.Hu YQ, Zhou XL, Yu WJ, et al. Ultrasonography findings in 60 cases of familial exudative vitreoretinopathy[J].Chinese J Ultrasound Med, 2015, 31(6):481-482.

Chinese Journal of Ocular Fundus Diseases

Diagnostic sensitivity and specificity of color Doppler flow imaging for persistent hyperplastic primary vitreous

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