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Long-Term Clinical Course in Eyes With Peters Anomaly
Haruna Yoshikawa1, Chie Sotozono, Yoko Ikeda
1Departments of *Ophthalmology; and †Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Insights
Peters anomaly (PA) can resolve naturally, with corneal opacity decreasing over time in some infants. Early, intensive amblyopia treatment is crucial for favorable visual outcomes in unilateral PA cases without glaucoma.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Genetics
Background:
- Peters anomaly (PA) is a leading cause of congenital corneal opacity.
- Understanding the natural history of PA is essential for guiding clinical management.
- Long-term outcomes for PA patients not undergoing corneal transplantation are not well-documented.
Purpose of the Study:
- To investigate the long-term clinical course and visual outcomes of infants with Peters anomaly.
- To evaluate patients with PA who were managed conservatively without keratoplasty.
Main Methods:
- Retrospective study of 9 infants (15 eyes) with PA presenting before 5 months of age.
- Follow-up duration exceeded 6 years post-initial presentation.
- Key data collected included visual acuity, intraocular pressure (IOP), glaucoma presence, and corneal opacity changes.
Main Results:
- Congenital glaucoma was present in 13 eyes of 7 patients.
- Corneal opacity showed gradual decrease in 4 eyes.
- Improved visual acuity was observed in a unilateral case with intensive amblyopia treatment and decreasing opacity.
Conclusions:
- Natural resolution of corneal opacity is possible in some cases of Peters anomaly.
- Aggressive amblyopia therapy is critical for achieving good vision in unilateral PA without elevated IOP or corneal enlargement.
Purpose:
Peters anomaly (PA) is known to be a primary cause of congenital corneal opacity. The aim of this study is to report the long-term clinical course and visual achievement of patients with PA who did not undergo keratoplasty.
Methods:
This retrospective study involved 15 eyes of 9 infants with PA less than 5 months of age at initial presentation at the Kyoto Prefectural University of Medicine who were followed up without keratoplasty for more than 6 years after presentation. In each subject, visual acuity, intraocular pressure (IOP), presence of congenital glaucoma, and change of corneal opacity were retrospectively investigated.
Results:
At initial presentation, the mean patient age was 2.3 months (SD: 1.3; range: 0-4 mo), and the mean follow-up period was 7.9 years (SD: 1.8; range: 6.5-11.3 yrs). Of the 9 patients, 6 were affected bilaterally. Thirteen eyes of 7 patients were found to have glaucoma. Over the follow-up period, corneal opacity gradually decreased in 4 eyes, 1 eye each of 2 unilateral patients without glaucoma and both eyes of 1 bilaterally affected patient with good IOP control during the follow-up period. Visual acuity in the unilateral case with intensive amblyopia treatment gradually increased along with decreasing corneal opacity.
Conclusions:
The findings of this study show that a natural decrease of corneal opacity can occur in eyes with PA. In cases of unilateral PA without IOP elevation and no enlargement of the corneal diameter, strict amblyopia treatment is vital to obtain a favorable visual prognosis.
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