title: Visual and anatomic outcomes with or without surgery in persistent fetal vasculature.
abstract: OBJECTIVE
  To determine visual and anatomic outcomes for patients with persistent fetal vasculature (PFV) observed or treated with surgery.
  
  
  METHODS
  Retrospective interventional consecutive case series.
  
  
  METHODS
  A total of 165 eyes of 150 patients diagnosed with PFV between January 1, 1983, and December 31, 2006, at the Bascom Palmer Eye Institute.
  
  
  METHODS
  Patients with media opacity, progressive glaucoma, or retinal detachment who were deemed to have visual potential underwent lensectomy, 3-port vitrectomy, or both, through a limbal or pars plicata/plana approach.
  
  
  METHODS
  Vision, postsurgical retinal attachment, lens status, need for eye removal, and rate of complications.
  
  
  RESULTS
  Of the 81 eyes that underwent surgical repair, 70 had at least 6 months of follow-up (median 47 months) and 49 (70.0%) had form vision, defined as finger counting, fix-and-follow, or better. Twenty (95.2%) of 21 eyes without form vision had a significant posterior component of PFV (P < 0.001). Forty eyes had limbal incisions, and 30 eyes had pars plicata incisions. The choice of surgical approach did not have a statistically significant effect on final visual acuity or rate of complications (P=0.43). Postoperative events occurred in 28 eyes (40.0%). Retinal attachment was achieved in 54 eyes (77.1%), and 61 eyes (87.1%) were left aphakic. Eighty-four eyes were not offered surgery, of which 78 eyes (92.9%) had a posterior component of PFV. The median age at diagnosis was greater compared with the surgical group (197 vs. 67.5 days, P=0.00545). Fifty-eight eyes (69.0%) lacked form vision, and 39 eyes (46.4%) had no light perception. Posterior manifestations of PFV, bilaterality, and microphthalmia were associated with poorer visual outcomes (P < 0.001, 0.041, and 0.002, respectively).
  
  
  CONCLUSIONS
  The majority of patients receiving surgical intervention for PFV achieved form vision. Posterior disease, microphthalmia, glaucoma, and amblyopia limited visual acuity outcomes even after aggressive intervention. The choice of limbal versus pars plicata approach produced similar visual and anatomic outcomes without a significant difference in rate of complications.
  
  
  BACKGROUND
  The author(s) have no proprietary or commercial interest in any materials discussed in this article.
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA. rsisk@cincinnatieye.com
authors.forename: Robert A
authors.initials: RA
authors.lastname: Sisk
authors.forename: Audina M
authors.initials: AM
authors.lastname: Berrocal
authors.forename: William J
authors.initials: WJ
authors.lastname: Feuer
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Murray
mesh_terms: D002648:Child; D002675:Child, Preschool; D005128:Eye Diseases / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007908:Lens, Crystalline / Q000601:surgery*; D008297:Male; D054514:Persistent Hyperplastic Primary Vitreous / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D012160:Retina / Q000503:physiopathology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy