About this item:
1,035 Views | 244 Downloads
Author Notes:
Correspondence: Scott R. Lambert, M.D., Emory Eye Center, 1365-B Clifton Rd, Atlanta, GA 30322; Email: slamber@emory.edu; Phone: 404-778-4417; Fax: 404-778-5203.
Disclosures: The authors have no proprietary or commercial interest in any materials discussed in this article.
Subject:
Research Funding:
Supported in part by NIH Departmental Core Grant EY06360 and Research to Prevent Blindness, Inc, New York, New York.
Congenital Fibrovascular Pupillary Membranes: Clinical and Histopathological Findings
Abstract:
Purpose: To report the clinical and histopathological findings associated with congenital fibrovascular pupillary membranes.
Design: Case series.
Participants: Seven infants; six with a unilateral congenital pupillary membrane and one with classic persistent fetal vasculature (PFV).
Methods: Patients underwent a membranectomy, pupilloplasty and/or a lensectomy. Histopathological examination was performed on the excised membranes.
Main Outcome Measures: Visual acuity and pupil size.
Results: Four of the 6 patients with a unilateral congenital pupillary membrane had one or more recurrences after a membranectomy and pupilloplasty. The most recent pupil size ranged from 2 to 5 mm in the affected eye. When last tested, the vision in the affected eye was excellent in 4 of the 6 patients. The two patients without recurrences of the pupillary membranes underwent multiple iris spincterotomies at the time of the initial surgery. Histopathological examination of two primary pupillary membranes showed fibrovascular tissue that did not stain for neuron specific enolase. Smooth muscle actin was only present in vascular walls. In contrast, histopathology of a recurrent pupillary membrane revealed collagenized fibrovascular tissue that was immunoreactive for smooth muscle actin. Finally, histopathology of the retrolenticular membrane excised from an infant with classic PFV was similar to the latter aside from hypercellularity.
Conclusions: Congenital fibrovascular pupillary membranes in infants are likely a variant of PFV that may recur if incompletely excised. The risk of these membranes recurring may be reduced by excising as much as the membrane as possible and enlarging the pupil with iris spincterotomies. A lensectomy should be avoided if possible.
Copyright information:
© 2011 American Academy of Ophthalmology, Inc. Published by Elsevier Inc. All rights reserved.
This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommerical-NoDerivs 3.0 Unported License (http://creativecommons.org/licenses/by-nc-nd/3.0/).
