Clinical observation of sclera buckle and vitrectomy treating different stages of familial exudative vitreoretinopathy associated rhegmatogenous retinal detachment_Chinese Journal of Ocular Fundus Diseases

Authors：

HeGuanghui ,  ChenSong , WangJian , WuBin , WangPing , GuoJing , LiCuiping , HanQuanhong , ChuYanhua , HanYing

Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, The Ophthalmic College of Tianjin Medical University, Tianjin 300020, China;

Corresponding author：

ChenSong, Email: chensong9999@126.com

Keywords：

Retinal detachment/surgery; Scleral buckling; Vitreoretinal surgery; Retinal diseases/congenital

DOI：

10.3760/cma.j.issn.1005-1015.2016.05.012

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Objective To observe the outcome of scleral buckle and vitrectomy for familial exudative vitreoretinopathy (FEVR) associated rhegmatogenous retinal detachment (RRD) with different stages. Methods Twenty eyes in 19 patients were included in this study. All the eyes were staged according to the staging system of FEVR. There are 7 eyes at stage 3A, 4 eyes at stage 4A, 6 eyes at stage 4B, and 3 eyes at stage 5. According to classification of retinal detachment (RD) with proliferative vitreoretinopathy (PVR), PVR B was in 5 eyes, PVR C1 in 2 eyes, PVR C2 in 3 eyes, PVR C3 in 7 eyes, PVR D1 in 3eyes. Retinal holes responsible for the RD could be found in every case. Scleral buckle or vitrectomy were chosen according to FEVR staging, PVR classification, location of retinal breaks, extent of RD.Ten eyes (stage 3A in 7 eyes, stage 4A in 3 eyes;PVR B in 5 eyes, PVR C1 in 2 eyes, PVR C2 in 3 eyes) were undergone scleral buckle, the mean preoperative minimum resolution angle in logarithmic (logMAR) best corrected visual acuity (BCVA) is 0.60±0.32.Ten eyes (stage 4A in 1 eyes,stage 4B in 6 eyes,stage 5 in 3 eyes;PVR C2 in 1 eyes,PVR C3 in 6 eyes,PVR D1 in 3 eyes) were undergone vitrectomy, the mean preoperative logMAR BCVA is 1.81±0.53. The mean follow up was(20.20±7.25) months, range 3 to 30 months. Surgical outcome were estimated by the average number of operation, reattachment of retina and BCVA. Results Final retinal attachment was obtained in 100% of all 20 eyes. The mean postoperative logMAR BCVA of scleral buckle group (0.34±0.32) is improved than preoperative BCVA, the difference wan statistically significant (t=2.932, P=0.017). The mean postoperative logMAR BCVA of vitrectomy group (1.42±0.64) is not changed compare with preoperative BCVA (t=1.812,P=0.103).The mean number of operation of scleral buckle group (1.10±0.32) is less than vitrectomy group's (2.20±0.42),the difference wan statistically significant (t=6.588, P=0.000). Conclusions Among the patients whose FEVR staging is less than 4A and PVR classification is less than C3,epiretinal membranes or subretinal membranes appears mild, and scleral buckle can achieve high success rate with less number of operations,and the BCVA is improved in most of the cases. For the patients whose FEVR staging is more than 4B and PVR classification is more than C3, proliferative vitreoretinopathy seems to be serious, retina can be effectively reattached via vitrectomy, however, the number of operations required is multiple, and the BCVA is probably unimproved after operation.

Citation： HeGuanghui, ChenSong, WangJian, WuBin, WangPing, GuoJing, LiCuiping, HanQuanhong, ChuYanhua, HanYing. Clinical observation of sclera buckle and vitrectomy treating different stages of familial exudative vitreoretinopathy associated rhegmatogenous retinal detachment. Chinese Journal of Ocular Fundus Diseases, 2016, 32(5): 510-513. doi: 10.3760/cma.j.issn.1005-1015.2016.05.012 Copy

1.	Yamane T, Yokoi T, Nakayama Y, et al. Surgical outcomes of progressive tractional retinal detachment associated with familial exudative vitreoretinopathy[J]. Am J Ophthalmol,2014, 158(5):1049-1055. DOI:10.1016/j.ajo.2014.08.009.
2.	Sigler EJ, Randolph JC, Calzada JI. Traction retinal detachment under silicone oil treated with two-port, 25-gauge pars plana vitrectomy and scissor segmentation in a child with familial exudative vitreoretinopathy[J]. Retin Cases Brief Rep,2013,7(3):183-187. DOI:10.1097/ICB.0b013e31827aee99.
3.	田超伟, 王雨生,苏晓娜,等.巩膜外垫压术治疗家族性渗出性玻璃体视网膜病变合并孔源性视网膜脱离[J].临床眼科杂志,2013,21(6):484-486. DOI:10.3969/j.issn.1006-8422.2013.06.002.TianCW,WangYS,SuXN,etal.Scleralbucklingtotreatfamilialexudativevitreoretinopathyassociatedrhegmatogenousretinaldetachment[J].JClinOphthalmol,2013,21(6):484-486.DOI:10.3969/j.issn.1006-8422.2013.06.002. .
4.	刘丽梅, 徐雁冰,孙英,等.巩膜扣带手术治疗家族性渗出性玻璃体视网膜病变合并孔源性视网膜脱离的疗效观察[J].中华眼底病杂志,2015,31(4):384-385. DOI:10.3760/cma.j.issn.1005-1015.2015.04.018. Liu LM,Xu YB,Sun Y,et al.Effects of scleral buckling for familial exudative vitreoretinopathy with rhegmatogenous retinal detachment[J].Chin J Ocul Fundus Dis,2015,31(4):384-385. DOI:10.3760/cma.j.issn.1005-1015.2015.04.018.
5.	Gilmour DF. Familial exudative vitreoretinopathy and related retinopathies[J].Eye (Lond), 2015,29(1):11-14. DOI:10.1038/eye.2014.70.
6.	Joussen AM, Gordes RS, Heuben FA,et al. Retinal exudative disease in childhood:Coats´ disease and familial exudative vitreoretinopathy(FEVR)[J]. Klin Monbl Augenheilkd, 2013, 230(9):902-913. DOI:10.1055/s-0033-1350689.
7.	The Retinal Society Terminology Committee.The classification of retinal detachment with proliferative vitreoretinopathy[J].Ophthalmology,1983,90(2):121-125.
8.	Lanchares E, Del Buey MA, Cristobal JA, et al.Computational simulation of scleral buckling surgery for rhegmatogenous retinal detachment:on the effect of the band size on the myopization. J Ophthalmol, 2016,2016:3578617.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4931101/.DOI:10.1155/2016/3578617.
9.	Mohamed YH, Ono K, Kinoshita H,et al. Success rates of vitrectomy in treatment of rhegmatogenous retinal detachment. J Ophthalmol, 2016, 2016:2193518. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4961815/.DOI:10.1155/2016/2193518.
10.	Holladay JT. Proper method for calculating average visual acuity[J].J Refract Surg, 1997, 13(4):388-391.
11.	Akabane N, Yamamoto S, Tsukahara I, et al. Surgical outcomes in juvenile retinal detachment[J]. Jpn J Ophthalmol, 2001,45(4):409-411.
12.	Ranchod TM, Ho LY, Drenser KA, et al. Clinical presentation of familial exudative vitreoretinopathy[J]. Ophthalmology, 2011,118(10):2070-2075. DOI:10.1016/j.ophtha.2011.06.020.
13.	王熙娟, 梁建宏,尹虹,等.巩膜扣带手术和玻璃体切割手术治疗家族性渗出性玻璃体视网膜病变疗效观察[J].中华眼底病杂志,2016,32(1):36-39.DOI:10.3760/cma.j.issn.1005-1015.2016.01.009. Wang XJ,Liang JH,Yin H,et al.Effects of scleral buckling and vitrectomy for familial exudative vitreoretinopathy[J].Chin J Ocul Fundus Dis,2016, 32(1):36-39.DOI:10.3760/cma.j.issn.1005-1015.2016.01.009.
14.	Chen SN, Hwang JF, Lin CJ. Clinical characteristics and surgical management of familial exudative vitreoretinopathy-associated rhegmatogenous retinal detachment[J]. Retina, 2012, 32(2):220-225. DOI:10.1097/IAE.0b013e31821c3ec5.
15.	John VJ, McClintic JI, Hess DJ,et al. Retinopathy of prematurity versus familial exudative vitreoretinopathy:report on clinical and angiographic findings[J]. Ophthalmic Surg Lasers Imaging Retina,2016,47(1):14-19. DOI:10.3928/23258160-20151214-02.
16.	Kashani AH, Brown KT, Chang E,et al. Diversity of retinal vascular anomalies in patients with familial exudative vitreoretinopathy[J]. Ophthalmology,2014,121(11):2220-2227.DOI:10.1016/j.ophtha.2014.05.029.
17.	Chen SN, Jiunn-Feng H, Te-Cheng Y. Pediatric rhegmatogenous retinal detachment in Taiwan[J]. Retina, 2006,26(4):410-414.
18.	Ikeda T,Fujikado T,Tano Y,et al. Vitrectomy for rhegmatogenous or tractional retinal detachment with familial exudative vitreoretinopathy[J]. Ophthalmology,1999,106(6):1081-1085.

1. Yamane T, Yokoi T, Nakayama Y, et al. Surgical outcomes of progressive tractional retinal detachment associated with familial exudative vitreoretinopathy[J]. Am J Ophthalmol,2014, 158(5):1049-1055. DOI:10.1016/j.ajo.2014.08.009.
2. Sigler EJ, Randolph JC, Calzada JI. Traction retinal detachment under silicone oil treated with two-port, 25-gauge pars plana vitrectomy and scissor segmentation in a child with familial exudative vitreoretinopathy[J]. Retin Cases Brief Rep,2013,7(3):183-187. DOI:10.1097/ICB.0b013e31827aee99.
3. 田超伟, 王雨生,苏晓娜,等.巩膜外垫压术治疗家族性渗出性玻璃体视网膜病变合并孔源性视网膜脱离[J].临床眼科杂志,2013,21(6):484-486. DOI:10.3969/j.issn.1006-8422.2013.06.002.TianCW,WangYS,SuXN,etal.Scleralbucklingtotreatfamilialexudativevitreoretinopathyassociatedrhegmatogenousretinaldetachment[J].JClinOphthalmol,2013,21(6):484-486.DOI:10.3969/j.issn.1006-8422.2013.06.002. .
4. 刘丽梅, 徐雁冰,孙英,等.巩膜扣带手术治疗家族性渗出性玻璃体视网膜病变合并孔源性视网膜脱离的疗效观察[J].中华眼底病杂志,2015,31(4):384-385. DOI:10.3760/cma.j.issn.1005-1015.2015.04.018. Liu LM,Xu YB,Sun Y,et al.Effects of scleral buckling for familial exudative vitreoretinopathy with rhegmatogenous retinal detachment[J].Chin J Ocul Fundus Dis,2015,31(4):384-385. DOI:10.3760/cma.j.issn.1005-1015.2015.04.018.
5. Gilmour DF. Familial exudative vitreoretinopathy and related retinopathies[J].Eye (Lond), 2015,29(1):11-14. DOI:10.1038/eye.2014.70.
6. Joussen AM, Gordes RS, Heuben FA,et al. Retinal exudative disease in childhood:Coats´ disease and familial exudative vitreoretinopathy(FEVR)[J]. Klin Monbl Augenheilkd, 2013, 230(9):902-913. DOI:10.1055/s-0033-1350689.
7. The Retinal Society Terminology Committee.The classification of retinal detachment with proliferative vitreoretinopathy[J].Ophthalmology,1983,90(2):121-125.
8. Lanchares E, Del Buey MA, Cristobal JA, et al.Computational simulation of scleral buckling surgery for rhegmatogenous retinal detachment:on the effect of the band size on the myopization. J Ophthalmol, 2016,2016:3578617.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4931101/.DOI:10.1155/2016/3578617.
9. Mohamed YH, Ono K, Kinoshita H,et al. Success rates of vitrectomy in treatment of rhegmatogenous retinal detachment. J Ophthalmol, 2016, 2016:2193518. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4961815/.DOI:10.1155/2016/2193518.
10. Holladay JT. Proper method for calculating average visual acuity[J].J Refract Surg, 1997, 13(4):388-391.
11. Akabane N, Yamamoto S, Tsukahara I, et al. Surgical outcomes in juvenile retinal detachment[J]. Jpn J Ophthalmol, 2001,45(4):409-411.
12. Ranchod TM, Ho LY, Drenser KA, et al. Clinical presentation of familial exudative vitreoretinopathy[J]. Ophthalmology, 2011,118(10):2070-2075. DOI:10.1016/j.ophtha.2011.06.020.
13. 王熙娟, 梁建宏,尹虹,等.巩膜扣带手术和玻璃体切割手术治疗家族性渗出性玻璃体视网膜病变疗效观察[J].中华眼底病杂志,2016,32(1):36-39.DOI:10.3760/cma.j.issn.1005-1015.2016.01.009. Wang XJ,Liang JH,Yin H,et al.Effects of scleral buckling and vitrectomy for familial exudative vitreoretinopathy[J].Chin J Ocul Fundus Dis,2016, 32(1):36-39.DOI:10.3760/cma.j.issn.1005-1015.2016.01.009.
14. Chen SN, Hwang JF, Lin CJ. Clinical characteristics and surgical management of familial exudative vitreoretinopathy-associated rhegmatogenous retinal detachment[J]. Retina, 2012, 32(2):220-225. DOI:10.1097/IAE.0b013e31821c3ec5.
15. John VJ, McClintic JI, Hess DJ,et al. Retinopathy of prematurity versus familial exudative vitreoretinopathy:report on clinical and angiographic findings[J]. Ophthalmic Surg Lasers Imaging Retina,2016,47(1):14-19. DOI:10.3928/23258160-20151214-02.
16. Kashani AH, Brown KT, Chang E,et al. Diversity of retinal vascular anomalies in patients with familial exudative vitreoretinopathy[J]. Ophthalmology,2014,121(11):2220-2227.DOI:10.1016/j.ophtha.2014.05.029.
17. Chen SN, Jiunn-Feng H, Te-Cheng Y. Pediatric rhegmatogenous retinal detachment in Taiwan[J]. Retina, 2006,26(4):410-414.
18. Ikeda T,Fujikado T,Tano Y,et al. Vitrectomy for rhegmatogenous or tractional retinal detachment with familial exudative vitreoretinopathy[J]. Ophthalmology,1999,106(6):1081-1085.

Chinese Journal of Ocular Fundus Diseases

Clinical observation of sclera buckle and vitrectomy treating different stages of familial exudative vitreoretinopathy associated rhegmatogenous retinal detachment

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