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Manifestations of persistent pupillary membrane
N F Bobrova1, T V Romanova2, O D Dovhan2
1Pediatric Ophthalmology Department, State Institution "The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine", Odesa, Ukraine. filatovbobrova@gmail.com.
International Ophthalmology
|February 7, 2025
Summary
Persistent pupillary membranes (PPM) with iridolenticular attachment are common and can cause significant visual loss, necessitating surgical removal. This study details their clinical and structural features in children.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Anatomical Pathology
Background:
- Persistent pupillary membranes (PPM) are congenital remnants of fetal vasculature.
- Understanding PPM's clinical and structural characteristics is crucial for managing visual impairment in children.
- Previous studies have not comprehensively analyzed a large cohort of PPM cases.
Purpose of the Study:
- To investigate the clinical and structural manifestations of persistent pupillary membranes (PPM).
- To characterize PPM types, associated ocular findings, and visual acuity outcomes.
- To utilize light and electron microscopy for detailed structural analysis of PPM.
Main Methods:
- Descriptive case series of 32 children (38 eyes) with various PPM types (2005-2023).
- Comprehensive ophthalmological examinations including biomicroscopy, gonioscopy, and imaging.
- Surgical removal and subsequent histological/electron microscopic examination of PPM in 17 eyes.
Main Results:
- Type II PPM (iridolenticular attachment) was dominant (76.3%), often causing significant visual loss (50%).
- PPM affected pupil size/configuration (44.76%) and anterior chamber angles (26.3%).
- Microphthalmia (34.2%) and microcornea (23.7%) were observed; lens remained transparent in 84.2%.
Conclusions:
- Iridolenticular PPM is the most prevalent type, frequently leading to visual impairment requiring surgical intervention.
- PPM significantly impacts pupil morphology and anterior segment structures.
- Histological analysis confirms PPM as a remnant of the tunica vasculosa lentis with mesodermal origin.
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