Fluorescein Angiography May Predict Surgical Outcomes of Tractional Retinal Detachment in Familial Exudative Vitreoretinopathy

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PURPOSE: To investigate factors associated with the surgical outcomes of tractional retinal detachment (TRD) in eyes with familial exudative vitreoretinopathy (FEVR). DESIGN: Retrospective chart review. SUBJECTS: Patients who underwent surgeries for TRD associated with FEVR between April 2011 and April 2022 and had a follow-up of ≥18 months were included in the analysis. METHODS: Vitrectomy was performed on 47 eyes, with scleral buckling in 4 eyes and simultaneous lensectomy in 26 eyes. MAIN OUTCOME MEASURES: Data, including sex, age at the first surgery, disease stage, extent of fibrovascular proliferation (FVP, within 3 hours or >3 hours), preoperative fluorescein angiography (FA) grading (grade 1: mild leakage caused by FVP, grade 2: severe leakage), surgical outcomes, and complications, were collected. RESULTS: The age at the initial surgery ranged from 1 month to 15 years (median: 6 months). Thirty-two eyes were from male patients, and 15 eyes were from female ones. Only 1 eye in 25 patients was affected. In 11 patients, bilateral eyes were involved. In total, 8 eyes presented with stage 3 FEVR, 31 with stage 4, and 8 with stage 5. The preoperative FA was performed on 38 of 47 eyes. There were 26 eyes with FA grade 1 and 12 eyes with FA grade 2. The retina was reattached in 33 (70.2%) eyes at the final examination. Based on the univariate logistic regression analysis, a higher retinal reattachment (RA) rate was significantly associated with a lower FEVR stage (P = 0.0001), FA grade (P = 0.0008), and preoperative extent of FVP (P = 0.02). In the multivariate logistic regression analysis, only FA grade was significantly associated with RA (P = 0.04, odds ratio: 9.0, 95% confidence interval: 1.2-7.0 × 10). CONCLUSION: Eyes with TRD associated with FEVR in patients with mild FA leakage had a higher RA rate. Hence, the use of FA in evaluating disease activity can be useful in predicting surgical outcomes. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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