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Therapeutic Effect Observation of Surgery on Congenital Fibrovascular Pupillary Membrane
Insights
Congenital fibrovascular pupillary membrane (CFPM) affects eyes with thickened corneas and shallow anterior chambers. Early surgery before age 3 significantly reduces amblyopia risk in children with CFPM.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Anatomic Pathology
Background:
- Congenital fibrovascular pupillary membrane (CFPM) is a rare condition affecting the eye.
- Understanding its clinical presentation and treatment outcomes is crucial for pediatric eye care.
Purpose of the Study:
- To retrospectively analyze the clinical characteristics of CFPM.
- To evaluate the therapeutic outcomes of different treatment modalities for CFPM.
Main Methods:
- Retrospective review of 13 eyes from 12 children diagnosed with CFPM.
- Analysis of clinical data, ophthalmic examinations, and treatment outcomes.
- Histopathological examination using hematoxylin-eosin staining.
Main Results:
- Most cases (83.3%) required surgical membranectomy.
- Affected eyes showed increased corneal and lens thickness, and shallower anterior chambers.
- Surgery improved visual acuity and pupil size; early surgery (≤3 years) reduced amblyopia risk.
Conclusions:
- CFPM eyes present with structural changes and typically normal intraocular pressure.
- Membranectomy is effective and safe, with low recurrence.
- Timely surgical intervention before age 3 is key to minimizing amblyopia.
Purpose:
To retrospectively analyze the clinical characteristics and therapeutic outcomes of congenital fibrovascular pupillary membrane (CFPM).
Methods:
Twelve children (13 eyes) diagnosed as having CFPM between November 2017 and January 2024 in Qingdao Eye Hospital were retrospectively reviewed. Basic information and ophthalmic examination results were analyzed. Different treatment outcomes were monitored. Pathological analysis was performed using hematoxylin-eosin staining.
Results:
Three eyes (25%) received conservative treatment, whereas 10 eyes (83.3%) underwent membranectomy. Compared to fellow eyes, the affected eyes exhibited increased central corneal and lens thickness, with decreased central anterior chamber depth (all P < .05). No significant difference was observed in mean preoperative intraocular pressure between the affected and fellow eyes, both within normal range. The median best corrected visual acuity (BCVA) for non-surgical cases was 0.9 llogarithm of the minimum angle of resolution (og-MAR) (Snellen equivalent of 0.125) with miosis. Surgical treatment improved the natural pupil size and median BCVA to 0.4 logMAR (Snellen equivalent of 0.4). Postoperative amblyopia was 100% and 33.3% in patients who underwent surgery after age 3 years and at or before 3 years, respectively (P = .035). No surgery-induced cataracts or recurrence in cases of unilateral involvement was noted. Histopathological analysis revealed that the excised tissue consisted of proliferative fibrous and vascular tissues with infiltrated inflammatory cells.
Conclusions:
Affected eyes in CFPM exhibit a thickened cornea and lens with a shallow anterior chamber, typically without glaucoma. Surgery is a safe and effective treatment with low recurrence and fewer complications compared to limited conservative treatment. Performing surgery before age 3 years reduces amblyopia risk. CFPM may be linked to chronic inflammation from incomplete degeneration of fetal eye vasculature. [J Pediatr Ophthalmol Strabismus. 2025;62(4):286-296.].
