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Concurrent vitrectomy for persistent pupillary membrane complicated by severe myopia and vitreomacular traction
Hiroyuki Nishi1, Ryohsuke Kohmoto, Masashi Mimura
1Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan.
Introduction:
In cases of persistent pupillary membrane (PPM), the eye is usually slightly microphthalmic and emmetropia or hyperopia is often present, yet severe myopia is reportedly rare. Here we presented a case of PPM complicated by vitreomacular traction syndrome and posterior staphyloma due to severe myopia.
Patient Concerns:
This study involved a 63-year-old female patient who had been diagnosed with bilateral PPM at a local eye clinic and who was subsequently referred to our department for a more detailed examination due to a recent decrease of visual acuity.
Diagnoses:
Slit-lamp microscopy examination revealed bilateral PPM. The ocular fundus revealed peripapillary conus and myopic change in both eyes. Optical coherence tomography examination revealed no particular abnormalities in the right eye, yet did show findings indicative of vitreomacular traction syndrome in the left eye.
Interventions:
In both eyes, we performed surgical removal of the PPM, phacoemulsification aspiration, and intraocular lens implantation, yet in the patient's left eye, vitrectomy was also performed.
Outcomes:
After surgery, the patient's visual acuity improved in both eyes.
Conclusion:
The findings in this case show that when required, vitrectomy should be considered based upon the preoperative Optical coherence tomography findings for PPM.
Insights
Persistent pupillary membrane (PPM) can rarely cause severe myopia. This case highlights the importance of considering vitrectomy for PPM patients with vitreomacular traction syndrome, improving visual acuity.
Area of Science:
- Ophthalmology
- Medical Case Reports
Background:
- Persistent pupillary membrane (PPM) is typically associated with mild microphthalmia and refractive errors like emmetropia or hyperopia.
- Severe myopia is an uncommon complication of PPM.
Observation:
- A 63-year-old female presented with decreased visual acuity.
- Bilateral PPM was diagnosed, with fundus examination revealing peripapillary conus and myopic changes.
- Optical coherence tomography (OCT) showed vitreomacular traction syndrome in the left eye.
Findings:
- Surgical removal of PPM, phacoemulsification, and intraocular lens implantation were performed bilaterally.
- Additional vitrectomy was performed on the left eye due to vitreomacular traction syndrome.
- Postoperative visual acuity improved in both eyes.
Implications:
- This case suggests that vitrectomy may be beneficial for PPM patients with coexisting vitreomacular traction syndrome.
- Preoperative OCT findings are crucial for determining the necessity of vitrectomy in PPM cases.
- Early intervention can lead to improved visual outcomes in complex PPM cases.
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