Diagnostic sensitivity and specificity of color Doppler flow imaging for persistent hyperplastic primary vitreous

Abstract

Objective To observe the diagnostic sensitivity and specificity of color Doppler flow imaging (CDFI) for persistent hyperplastic primary vitreous (PHPV). Methods The clinical data of 71 children (93 eyes) with congenital cataract which suspected of concurrent PHPV were retrospectively analyzed. The children included 45 males (54 eyes) and 26 females (39 eyes), aged from 1 to 24 months, with an average age of (7.6±4.3) months. All eyes were examined by CDFI, and observe whether there was a pathological strip in the vitreous, the site of the connection between the strip echo and the wall of the eye and the signal of blood flow on the strip echo. Within 1 week after a CDFI examination under general anesthesia, 64 children (79 eyes) underwent lens excision combined with vitrectomy and the other 14 eyes of 7 children underwent mydriatic fundus examination by two experienced eye specialists. Combined with clinical features of PHPV, the diagnosis and differential diagnosis were made according to the clouding of the lens, posterior capsule proliferation, vitreous proliferation and retinal detachment position which were found during operation and fundus examination. Compare and analyze the CDFI examination results and the above diagnosis results, calculate the sensitivity and specificity of CDFI for PHPV. Results In surgery and mydriatic fundus examination results of 93 eyes, vitreous abnormal in 85 eyes, no significant changes were found in vitreous of the other 8 eyes. In 85 eyes of abnormal vitreous, 68 eyes were diagnosed as PHPV, 16 eyes were diagnosed as familial exudative vitreoretinopathy (FEVR), and 1 eye was diagnosed as treactional retinal detachment. In 85 eyes of abnormal vitreous which were found by surgery and fundus examination, CDFI confirmed 81 eyes and its diagnostic sensitivity was 95.3%; the other 4 eyes were not found vitreous abnormality, and the missed diagnosis rate was 4.7%. Surgery and mydriatic fundus examination found no vitreous abnormal in 8 eyes, but CDFI explored strip low echo connected with the optic disc or posterior lens capsule in vitreous. In the 68 eyes of PHPV which were diagnosed by surgery or fundus examination, 59 eyes had the same diagnosis of CDFI, the sensitivity of CDFI was 86.8%; PHPV was not diagnosed in 25 eyes by surgery or fundus examination, but only 8 eyes were also not diagnosed by CDFI, and the specificity of CDFI was 32.0%. The remaining 17 eyes were diagnosed as FEVR in 16 eyes and traction retinal detachment in 1 eye after surgery or mydriatic fundus examination, but they were all diagnosed as PHPV in CDFI. The misdiagnosis rate of CDFI was 68.0%. Conclusion For PHPV, the diagnostic sensitivity and specificity of CDFI are 86.8% and 32.0%, respectively. Key words: Persistent hyperplastic primary vitreous/diagnosis; Ultrasonography, doppler, color