World journal of clinical pediatrics · 2026
Autologous in vitreo generated plasmin assisted vitrectomy in the pediatric population.
СтатьяНазвание и аннотация: Перевод в очереди
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Subramaniam Prema, Jacob Ninan, Saravanan Veerappan Rathinasabapathy, Shah Parag K, Das Abhishek, Venkatapathy Narendran
Аннотация
BACKGROUND: Inducing posterior vitreous detachment (PVD) is a crucial step in vitreoretinal surgery. However, compared with older patients, induction of PVD in pediatric and young adult populations is considerably more difficult. Recent studies have shown the utility of autologous plasmin enzyme in inducing PVD in pediatric patients.
AIM: To evaluate the anatomical and functional outcomes of patients with retinal detachment, treated with in vivo generated autologous plasmin, as an adjunct to vitreoretinal surgery.
METHODS: This is a retrospective observational case series including ten eyes of nine patients with retinal detachment, secondary to various pathologies. All eyes that received simultaneous intravitreal injection of 0.1 mL of autologous blood and 25 μg of tissue plasminogen activator (t-PA) 3 days before surgery were analyzed.
RESULTS: The mean age of the cohort was 9.3 +/- 4.16 years, ranging from 5 years to 16 years. Four out of nine patients were female. Five of the ten eyes had previously undergone vitreoretinal surgery. In the study cohort, five patients had high myopia, two patients had Stickler's syndrome, one had juvenile X-lined retinoschisis, and one had familial exudative vitreoretinopathy associated with retinal detachment. No eye required repeat vitreoretinal surgery for recurrent retinal detachment or membrane peeling following the primary procedure, with adjunctive intravitreal autologous plasmin the median baseline visual acuity was 2.30 logarithm of the minimum angle of resolution (LogMAR) [interquartile range (IQR): 1.85-2.60], and the median final visual acuity was 1.54 LogMAR (IQR: 1.08-1.78), showing a statistically significant improvement (P = 0.01), with five eyes regaining functional visual acuity.
CONCLUSION: Adjunctive intravitreal autologous plasmin improves the anatomical outcome of vitreoretinal surgery in pediatric patients. However these findings require validation in a large sample, prospective study.
AIM: To evaluate the anatomical and functional outcomes of patients with retinal detachment, treated with in vivo generated autologous plasmin, as an adjunct to vitreoretinal surgery.
METHODS: This is a retrospective observational case series including ten eyes of nine patients with retinal detachment, secondary to various pathologies. All eyes that received simultaneous intravitreal injection of 0.1 mL of autologous blood and 25 μg of tissue plasminogen activator (t-PA) 3 days before surgery were analyzed.
RESULTS: The mean age of the cohort was 9.3 +/- 4.16 years, ranging from 5 years to 16 years. Four out of nine patients were female. Five of the ten eyes had previously undergone vitreoretinal surgery. In the study cohort, five patients had high myopia, two patients had Stickler's syndrome, one had juvenile X-lined retinoschisis, and one had familial exudative vitreoretinopathy associated with retinal detachment. No eye required repeat vitreoretinal surgery for recurrent retinal detachment or membrane peeling following the primary procedure, with adjunctive intravitreal autologous plasmin the median baseline visual acuity was 2.30 logarithm of the minimum angle of resolution (LogMAR) [interquartile range (IQR): 1.85-2.60], and the median final visual acuity was 1.54 LogMAR (IQR: 1.08-1.78), showing a statistically significant improvement (P = 0.01), with five eyes regaining functional visual acuity.
CONCLUSION: Adjunctive intravitreal autologous plasmin improves the anatomical outcome of vitreoretinal surgery in pediatric patients. However these findings require validation in a large sample, prospective study.