ObjectiveTo observe the clinical outcome of minimally invasive vitrectomy for ocular toxocariasis (OT). MethodsThe clinical data of 37 eyes in 37 patients with OT who underwent 23-gauge vitrectomy were retrospectively reviewed. There were 27 male patients and 10 female patients. The age was from 9 months to 22 years, with the mean age of (7.90±4.47) years. Patients who can cooperate underwent non-contact tonometer examination, slit lamp examination, fundus photography, ultrasound examination, optical coherence tomography and ultrasound biomicroscopic examination. The visual acuity was from no light perception to 0.6. According to the clinical type of OT, 18 eyes had posterior granuloma, 13 eyes had peripheral granuloma, 4 eyes had endophthalmitis and 2 eyes had atypical presentation. Seventeen eyes had vitrectomy for tractional retinal detachment (TRD), 13 eyes for epiretinal membrane (ERM), 6 eyes for TRD combined with ERM and 1 eye for endophthalmitis. Twenty-five eyes had lens-sparing vitrectomy, 12 eyes had lensectomy with vitrectomy; five eyes had limbus incision and 32 eyes had pars plana incision. Five eyes (13.51%) had reoperation. Followed up from 6 months to 39 months, with the mean of (13.90±10.25) months. ResultsVision improved in 25 of 35 eyes (71.43%), was unchanged in 9 eyes (25.71%), and was declined in 1 eye (2.86%). Retina was reattached in 22 of 23 eyes that had TRD before surgery (95.65%); the rest one eye had redetachment (4.35%). Three eyes had cataract after surgery, which accounted for 12% in lens-sparing eyes. Among them, 2 eyes had lensectomy therefore. ERM was removed and had no recurrence in 18 of 19 eyes (94.74%). ConclusionMinimally invasive vitrectomy for OT patients can improve their vision and achieve retinal reattachment.
ObjectiveTo observe the application value and therapeutic efficacy of wide-field digital pediatric retinal imaging system (RetcamⅢ) fundus fluorescein angiograms (FFA) assisted photocoagulation on familial exudative vitreoretinopathy (FEVR). MethodsThe study included 46 eyes of 34 patients with staging 2 FEVR. All patients received color fundus photography and FFA under general anesthesia. The blood vessel reliability of color fundus photography and FFA was comparatively determined. Binocular indirect ophthalmoscope laser photocoagulation was applied to peripheral retina with abnormal leakage as indicated by FFA, the wavelength was 532nm, the duration was 0.25 s and the energy was 200-280 mW. After laser photocoagulation, fundus imaging and FFA was repeated. Further laser photocoagulation was immediately added to areas with vessel leakage but missing the photocoagulation. After treatment, the mean follow-up duration was 14.4 months. The follow up focused on neovascularization, exudative lesions, vitreous traction and merging of photocoagulation spots within 3 months, and on fibrosis membrane resulting in macular traction, tractional retinal detachment, vitreous hemorrhage or Coats disease-like retinal exudates after 3 months. ResultsIt was hard to identify the blood vessels based on the color fundus images and some avascular zone maybe missed. Neovascularization can't be determined by shape of the blood vessels. On the other hand, those new blood vessels can be easily recognized by FFA as leakage sites at the boundary of avascular zone. The surgeon could quickly and accurately locate the FEVR area guided by the color fundus images and FFA from same angle under binocular indirect ophthalmoscope. During the treatment, there was no retinal FEVR area missed laser photocoagulation for all patients. There was no neovascularization, exudative lesions, vitreous traction within 3 months, and no fibrosis membrane, tractional retinal detachment, vitreous hemorrhage or Coats disease-like retinal exudates after 3 months. There were no ocular and systemic complications during and after the FFA and laser photocoagulation. ConclusionWide-field RetcamⅢFFA can help retinal specialists to identify abnormal neovascularization, locate the lesion area, and thus increase the success rate of laser photocoagulation, reduce the ocular and systemic complications for FEVR.