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RETINAL DETACHMENT IN MARFAN SYNDROME: CLINICAL CHARACTERISTICS AND SURGICAL OUTCOME

SHARMA, TARUN MD; GOPAL, LINGAM MD; SHANMUGAM, MAHESH P. MD; BHENDE, PRAMOD S. MD; AGRAWAL, RAJAT MD; SHETTY, NITIN S. MD; GOPALAKRISHNA, MAHESH MD; RAO, MADHAV K. MD; Balusamy, SUKUMAR MPhil

Article

Purpose: To describe the clinical characteristics of retinal detachments in patients with Marfan syndrome and report the surgical outcome of vitreoretinal surgery.

Methods: Records relating to 53 eyes of 45 patients with Marfan syndrome who underwent surgery for rhegmatogenous retinal detachment were reviewed. Of the 53 eyes, 24 (45.3%) underwent scleral buckling as the first procedure and 29 (54.7%) underwent vitrectomy surgery with scleral buckle as the first procedure. Main outcome measures included clinical characteristics of retinal detachment, reattachment rates, and functional improvement in vision.

Results: Characteristic findings included total retinal detachment in 40 (75.5%) eyes, atrophic holes in 24 (45.3%) eyes, more than four retinal breaks in 21 eyes (39.6%), preequatorial and postequatorial breaks in 20 (37.7%) eyes, giant retinal tears in six (11.3%) eyes, and proliferative vitreoretinopathy (posterior, anterior, or both) in nine (17%) eyes. In 30 (56.6%) eyes, retinal breaks were located only in the temporal half of the retina. Of the 24 eyes with myopia, 13 (54.2%) had a myopic correction greater than 7 diopters. At the median follow-up of 10.7 months, complete retinal reattachment was obtained in 87.6% and 86.2% of patients undergoing scleral buckling (including additional procedures such as vitrectomy) and vitrectomy surgery, respectively. In eyes with reattached retinas, a final visual acuity of 20/200 or better was obtained in 81% of the patients after scleral buckling and in 56% of the patients after vitrectomy surgery (P = 0.07).

Conclusions: Retinal detachment in Marfan syndrome is complete in 75% of the eyes. More than half (56%) the eyes had a retinal break only in the temporal half of the retina, and 83% had at least a break in the temporal half of the retina. Currently available vitreoretinal surgical techniques result in successful reattachment of the retina in approximately 86% of the eyes.

From the Vitreoretinal Service, Sankara Nethralaya, Vision Research Foundation, Chennai, India.

Reprint requests: Tarun Sharma, MD, Sankara Nethralaya, 18 College Road, Chennai 600 006, India; e-mail: drts@sankaranethralaya.org

Supported by the Vision Research Foundation, Chennai, India.

Presented in poster form (P299) at the annual meeting of the American Academy of Ophthalmology; 2000.

The authors have no proprietary interest in the publication of this manuscript.

© The Ophthalmic Communications Society, Inc.