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Persistent Pupillary Membrane

Pupillary Membranes


Presentation

  • To present the management of a rare case of persistent pupillary membrane (PPM) associated with high myopia and amblyopia. A 12-year-old boy presented with progressive diminution of vision in the right eye since childhood.[ncbi.nlm.nih.gov]
  • CONCLUSIONS: In children with persistent pupillary membrane, there were no intraoperative complications, and only two patients presented with lens change during the long-term postoperative follow-up period.[ncbi.nlm.nih.gov]
  • We examined a 9-year-old child with bilateral hyperplastic persistent pupillary membranes present since birth. The patient had a visual acuity of BE, 20/30, stereopsis of 50 seconds of arc, orthophoria, and normal extraocular movements.[ncbi.nlm.nih.gov]
  • We describe a case of bilateral total PPM in a 36-year-old female who presented with complaints of blurred vision in both the eyes. Dense pupillary membranes obscuring the visual axis need early surgical treatment.[ncbi.nlm.nih.gov]
  • Two infants, aged three days and six weeks, respectively, presented with dense extensive persistent pupillary membranes as sporadic isolated findings. A clear central pupillary aperture was unable to be achieved with mydriatic agents.[ncbi.nlm.nih.gov]
Developmental Delay
  • The patient had associated omphalocele, sensorineural hearing loss, and developmental delay. Magnetic resonance imaging revealed agenesis of the corpus callosum.[ncbi.nlm.nih.gov]
Aspiration
  • The purpose of using Malyugin ring in this case was to avoid intraoperative bleeding caused by cutting blood vessels that might have been present within the pupillary membrane, to secure a wide and stable pupil, to avoid accidental aspiration of the membrane[ncbi.nlm.nih.gov]
  • The Provisc was removed with a Simco irrigation/aspiration canula. The corneal wounds each required a single 10/0 nylon suture which were removed under anaesthetic 3 months postoperatively.[bjo.bmj.com]
Esotropia
  • A 2-year-old boy presented with an abnormal pupillary aperture in his left eye, associated with a 20 prism diopter esotropia.[reviewofophthalmology.com]
Suggestibility
  • We suggest that early intervention in the first weeks or months of life is necessary to prevent the development of amblyopia. If mydriasis is unsuccessful, surgery is recommended followed by optical correction and occlusion therapy as necessary.[ncbi.nlm.nih.gov]
  • The presence of a mesodermal pupillary membrane despite absence of the iris suggested a primary neuroectodermal defect as the pathogenetic factor in this case of aniridia.[ncbi.nlm.nih.gov]
  • We suggest that the surgery with vitreous scissors is better than with Vannas scissors.[ncbi.nlm.nih.gov]
  • The author suggests a trial of refractive correction and occlusion therapy before deciding on surgical and laser intervention, even if it seems an absolute requirement.[ncbi.nlm.nih.gov]
  • This result suggests that more severe occlusion by hyperplastic persistent pupillary membrane in the neonatal period can cause more severe ametropia associated with either a myopic, hyperopic, or cylindrical trend.[healio.com]
Broad Nasal Bridge
  • Facial manifestations included broad nasal bridge, hypertelorism, and downward-slanting of palpebral fissures. The patient had associated omphalocele, sensorineural hearing loss, and developmental delay.[ncbi.nlm.nih.gov]
Hypertelorism
  • Facial manifestations included broad nasal bridge, hypertelorism, and downward-slanting of palpebral fissures. The patient had associated omphalocele, sensorineural hearing loss, and developmental delay.[ncbi.nlm.nih.gov]

Treatment

  • The mean absolute value of anisometropia was greater in the surgical treatment group than in the medical treatment and observation groups (P .048).[ncbi.nlm.nih.gov]
  • Surgical removal should be considered a safe and effective treatment for patients with visually significant persistent pupillary membrane. 2018 The Korean Ophthalmological Society.[ncbi.nlm.nih.gov]
  • The author describes his experience about the choice of laser energy and technical methods used in Nd:YAG laser treatment of persistent pupillary membrane, and discusses the intra- and post-operative complications, too.[ncbi.nlm.nih.gov]
  • Dense pupillary membranes obscuring the visual axis need early surgical treatment. It is essential that the lens status remains clear along the visual axis both before and after pupilloplasty.[ncbi.nlm.nih.gov]
  • […] modality: a surgical treatment group, a medical treatment group, and an observation group.[healio.com]

Prognosis

  • Although visual prognosis for properly managed patients is favorable, close follow-up of VA is needed since there is a chance of deprivation amblyopia. 6 Our case represents a PPM with acceptable pupillay opening in whom appropriate management resulted[academic.oup.com]
  • Surgery is generally performed in the first weeks or months of life, with good visual prognosis and consists of excision of the pupillary membrane using Vannas or vitreous scissors.[reviewofophthalmology.com]
  • In this study, we reviewed the medical records of 39 eyes with hyperplastic persistent pupillary membrane not associated with any other ocular anomaly affecting visual outcome and evaluated die visual prognosis and refractive change.[healio.com]
  • In cases such as this one, tests of macular function like entoptic tests, retina acuity meter (RAM) or laser interferometry can be performed to confirm the status of the macula and the visual prognosis.[djo.harvard.edu]

Prevention

  • We suggest that early intervention in the first weeks or months of life is necessary to prevent the development of amblyopia. If mydriasis is unsuccessful, surgery is recommended followed by optical correction and occlusion therapy as necessary.[ncbi.nlm.nih.gov]
  • Firstly, the argon laser was used to photocoagulate the part of the membrane adhering to the iris surface and so to prevent any bleeding caused by the YAG laser.[ghrnet.org]
  • Reynolds et al. suggested that prompt therapeutic intervention within the first few weeks or months of life is necessary to prevent amblyopia.6 Surgical excision, however, has its own complications such as hyphema and cataracts in addition to the risk[healio.com]
  • Teaching Hospital in Karachi Qidwai W, Waheed S, Ayub S, Syed, IA Role of Flax and Flax Gum in Health and Diabetes Mitra A, Bhattacharya D CABG at SKIMS - An Initial Experience Lone RA, Ahangar AG, Zubair H, Hussain Z, Dar AM Does HIV Infection Afford a Prevention[indmedica.com]
  • […] pupillary dilation, because of adherences between pupillary membrane and the iris, or posterior synechiae.(7)When the red reflex is no longer visible or severely compromised, surgery should immediately be indicated, with the aim to rescue the view and prevent[docslide.us]

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