Charles L. Schepens

Familial Exudative Vitreoretinopathy

The signs and symptoms of familial exudative vitreoretinopathy vary widely, even within the same family. In many affected individuals, the retinal abnormalities never cause any vision problems. In others, a reduction in the retinas blood supply causes the retina to fold, tear, or separate from the back of the eye (retinal detachment). This retinal damage can lead to vision loss and blindness. Other eye abnormalities are also possible, including eyes that do not look in the same direction (strabismus) and a visible whiteness (leukocoria) in the normally black pupil.

Posterior Hyperplastic Primary Vitreous

Congenital retinal fold (congenital retinal septum, ablatio falciformis congenita) is a rare occurrence and is frequently misdiagnosed. Often it is only one of a group of ocular anomalies which appear to result from a posterior form of persistent or hyperplastic primary vitreous. This report presents our findings in a sexad ries of patients with this syndrome, reviews current theories of pathogenesis, and comxad ments on the clinical significance of abnorxad mal vitreoretinal development.

Subtotal Open-Sky Vitrectomy for Severe Retinal Detachment Occurring as a Late Complication of Ocular Trauma

Subtotal open-sky vitrectomy was performed on 50 eyes with severe retinal detachment that developed as a late complication of ocular trauma. The retina was reattached in 32% of the eyes and vision was improved in 50% of the reattached cases. Two cases of giant retinal tear with massive preretinal retraction were successfully treated by suturing the retinal flap of the tear to the choroid. Subtotal open-sky vitrectomy may be helpful in cases in which closed vitrectomy has failed or would be likely to fail.

Chorioretinal Anastomoses after Argon Laser Photocoagulation

Communication between the retinal and the choroidal circulation occurred in one case of proliferative diabetic retinopathy and one case of Lebers disease (multiple miliary aneurysms) after argon laser photocoagulation treatment to eliminate abnormal retinal vasculature. In both instances rapid-sequence fluorescein angiography documented the choroidal origin of the anastomoses. Such anastomoses developed in areas where an excessively dense laser beam aimed at occluding retinal vessels presumably destroyed the underlying Bruchs membrane and permitted invasion of the retina by fibrovascular growth from the choriod. The occurrence of such growths is a potential complication of argon laser photocoagulation directly related to the power density used.