To describe the characteristics and treatment outcomes of an unreported, late
vitreous hemorrhage due to anterior hyaloidal fibrovascular proliferation in
laser-regressed
retinopathy of prematurity (ROP). Interventional case series. In the ongoing Indian Twin Cities ROP study database, consecutive cases with isolated late
vitreous hemorrhage at least one year after
laser-regressed disease were analyzed retrospectively. Anterior hyaloidal fibrovascular proliferation was diagnosed primarily using scleral depression. Anterior
retinal cryopexy with adjunctive treatments was performed. The main outcome measure was clinical resolution of new vessels with no recurrent
hemorrhage over a 1-year period.
Vitreous hemorrhage, at two to eight years of age, developed in three eyes of three children out of 1,168 ROP lasered eyes. All had received
laser for zone I disease as neonates, with no subsequent sequelae. Evaluation revealed filiform new vessels at the posterior vitreous base involving inferior 180° with absence of any other source of
hemorrhage. All underwent anterior
retinal cryopexy to the affected area. Simultaneous additional treatment, based on intraoperative findings, included one case each of peripheral
laser photocoagulation, lens-sparing
vitrectomy and intravitreal
bevacizumab. All three showed successful regression and non-recurrence of
vitreous hemorrhage with improvement of vision >20/40 at an intermediate follow-up of two years. Anterior hyaloidal fibrovascular proliferation is an unreported and rare cause of
vitreous hemorrhage, appearing years after
laser-regressed ROP. It has a good response to interventional treatment. Meticulous scleral depression of the vitreous base under
anesthesia is useful to detect this rare source of
vitreous hemorrhage.