Ahmad M Mansour1,2, Igor Kozak3, Ali Osman Saatci4, Francisco J Ascaso5,6, Laura Broc7, Maurizio Battaglia8, Nuria Olivier9, Pablo Gili10, Jay Chhablani11, Thomas R Hedges12, Ana Honrubia5,6, Laura Gutierrez13, Giacomo Panozzo14, Jaume Català15, Jesús Díaz15, Elisa Carreras15, Sibel Kadayifcilar16, Eman S Al Kahtani17, Sami H Uwaydat18, Luiz H Lima19, Hana A Mansour20, Hashim Ali Khan21, Thomas M Aaberg22, Jerald A Bovino23, Alex P Hunyor24. 1. Department of Ophthalmology, American University of Beirut, Beirut, Lebanon. ammansourmd@gmail.com. 2. Department of Ophthalmology, Rafik Hariri University Hospital, Beirut, Lebanon. ammansourmd@gmail.com. 3. Vitreoretinal Service, Moorfields Eye Hospital UAE, Abu Dhabi, UAE. 4. Department of Ophthalmology, Dokuz Eylul University, Izmir, Turkey. 5. Department of Ophthalmology, Hospital Clínico Universitario "Lozano Blesa", Zaragoza, Spain. 6. Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain. 7. Instituto de Oftalmología Castanera, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain. 8. Department of Ophthalmology, Ospedale San Raffaele, University Vita-Salute Milan, Milan, Italy. 9. Department. Of Ophthalmology, XXI Ferrol, Galicia, Spain. 10. Department of Ophthalmology, Hospital Universitario Fundación Alcorcón, Madrid, Spain. 11. Smt. Kanuri Santhamma Retina Vitreous Centre, L.V. Prasad Eye Institute, Kallam Anji Reddy Campus, Banjara Hills, Hyderabad, India. 12. Department of Ophthalmology, Tufts Medical Center, Boston, MA, USA. 13. Consorci Sanitari de Terrassa, Barcelona, Spain. 14. Vitreoretinal Unit, Istituto Clinico S. Anna, Brescia, Italy. 15. Unitat de Retina, Servei d'Oftalmologia, Hospital Sant Joan de Déu, Barcelona, Spain. 16. Department. of Ophthalmology, Hacettepe University Faculty of Medicine, Ankara, Turkey. 17. The Eye Consultants, Riyadh, Saudi Arabia. 18. Jones Eye Institute, University of Arkansas Medical Sciences, Little Rock, AR, USA. 19. Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo, Sao Paulo, Brazil. 20. Department of Ophthalmology, American University of Beirut, Beirut, Lebanon. 21. Sehhat Foundation Hospital, Danyore, Gilgit, Pakistan. 22. Retina Specialists of Michigan, Grand Rapids, MI, USA. 23. Department of Ophthalmology, Medical College of Ohio, Toledo, OH, USA. 24. Sydney Eye Hospital, University of Sydney, Sydney, NSW, Australia.
Abstract
BACKGROUND/ OBJECTIVES: To analyze the ophthalmic characteristics of congenital prepapillary vascular loop (PVL) and to propose a new morphologic classification dividing the loops into six types. SUBJECTS/ METHODS: Collaborative multinational multicentre retrospective study of PVL cases. RESULTS: There was a total of 49 cases (61 eyes), 37 unilateral (75.5%) and 12 bilateral (24.5%), 32 arterial type (65.3%) and 18 venous type (36.7%) (one patient had either kind in each eye). The mean number of loops per eye was 2.7 (range, 1-7). The loops were asymptomatic in 42 cases (85.7%). Other findings included: the presence of cilioretinal artery (14 cases), retinal vascular tortuosity (26 cases), amaurosis fugax (1 case), branch retinal artery occlusion (1 case) and vitreous haemorrhage (3 cases). Six morphologic loop types could be discerned based on elevation (flat vs. elevated), shape (figure of 8 or corkscrew with hyaline sheath), number (multiple or single), location (central or peripheral), lumen size (arterial vs. arteriolar) and presence of vascular tortuosity or vitreous traction. CONCLUSIONS: PVL are usually asymptomatic and can be divided into six morphologic types with different pathogenesis during early embryogenesis.
BACKGROUND/ OBJECTIVES: To analyze the ophthalmic characteristics of congenital prepapillary vascular loop (PVL) and to propose a new morphologic classification dividing the loops into six types. SUBJECTS/ METHODS: Collaborative multinational multicentre retrospective study of PVL cases. RESULTS: There was a total of 49 cases (61 eyes), 37 unilateral (75.5%) and 12 bilateral (24.5%), 32 arterial type (65.3%) and 18 venous type (36.7%) (one patient had either kind in each eye). The mean number of loops per eye was 2.7 (range, 1-7). The loops were asymptomatic in 42 cases (85.7%). Other findings included: the presence of cilioretinal artery (14 cases), retinal vascular tortuosity (26 cases), amaurosis fugax (1 case), branch retinal artery occlusion (1 case) and vitreous haemorrhage (3 cases). Six morphologic loop types could be discerned based on elevation (flat vs. elevated), shape (figure of 8 or corkscrew with hyaline sheath), number (multiple or single), location (central or peripheral), lumen size (arterial vs. arteriolar) and presence of vascular tortuosity or vitreous traction. CONCLUSIONS: PVL are usually asymptomatic and can be divided into six morphologic types with different pathogenesis during early embryogenesis.