A rare case of persistent pupillary membrane: Case-based approach and management

Banigallapati, Shashidhar; Potti, Sudhakar; Marthala, Himabindu

doi:10.4103/ijo.ijo_495_18

Cited by 15 publications

(9 citation statements)

References 9 publications

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“…This may have been due to the decreased retinal illumination and diffraction caused by a small opening pupil, which may produce deprivation amblyopia [24,25]. Treatment with topical mydriatic agents or with membranectomy by laser or surgery is used for dense or thick membranes [1]. For amblyopic eyes, further eye patching and refractive correction treatment, especially astigmatism correction, is needed.…”

Section: Discussionmentioning

confidence: 99%

“…Small PPM can be managed conservatively with observation only or by topical mydriatic agents [26]. Thick or dense membranes can hinder visual development, as pupillary apertures < 1.5 mm may obscure the light reaching the retina and occlude the visual axis [1]. For these patients, early intervention, such as membranectomy by Nd:YAG laser or Argon laser or high-viscosity viscoelastic protected surgical membranectomy, should be considered to reduce the risk of deprivation amblyopia [13,[27][28][29].…”

Section: Discussionmentioning

confidence: 99%

“…Persistent pupillary membrane (PPM), appearing as iris strands along the pupil in the anterior chamber, represents a congenital ocular anomaly [1]. Thick or dense membranes can occlude the visual axis and affect visual development.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Corneal Curvature and Astigmatism in Patients with Persistent Pupillary Membrane by Partial Coherence Interferometry Measurements

Yang

et al. 2020

Ophthalmic Res

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Purpose: To evaluate and compare the corneal curvature and astigmatism in patients with persistent pupillary membrane (PPM) and healthy controls by partial coherence interferometry. Methods: This study included 14 eyes (9 patients) with PPM and 16 eyes (16 subjects) without PPM or other ocular disease, which were age and gender matched. The horizontal corneal radius of curvature (hCRC), vertical CRC (vCRC), average CRC (aveCRC), corneal astigmatic vectors (CAV), and axis were recorded using partial coherence interferometry. Uncorrected visual acuity and best corrected visual acuity (BCVA) were also recorded using a logMAR chart. Results: In the PPM group, the vCRC (45.46 ± 0.52 D) was significantly larger than that in the control group (44.05 ± 0.24 D) (p = 0.009). The aveCRC in the PPM group (43.90 ± 0.46 D) was also significantly larger than that in the control group (43.34 ± 0.23 D) (p = 0.018). In the PPM group, the hCRC (42.35 ± 0.41 D) was significantly smaller than that in the control group (42.63 ± 0.24 D) (p = 0.049). The astigmatisms were with-therule in both groups. The absolute value of CAV in PPM group (3.17 ± 0.23 D) was significantly higher than that of control (1.36 ± 0.09 D) (p = 0.001). BCVA (0.42 ± 0.08) in PPM group was significantly worse than that in control (0.90 ± 0.03) (p = 0.009). Conclusions: The larger vertical and smaller horizontal corneal curvature resulted in higher corneal astigmatism with the rule, which is a characteristic feature in patients with PPM. More attention should be paid to astigmatism status and correction treatment for these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Evaluation of Corneal Curvature and Astigmatism in Patients with Persistent Pupillary Membrane by Partial Coherence Interferometry Measurements

Yang

et al. 2020

Ophthalmic Res

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“…PPM appears as fine iris strands along the pupil and can be seen in 95% of neonates and 20% of adult population (3). While PPMs not affecting vision are common and require no treatment (4,5), dense membrane can hinder vision development as less than 1.5 mm pupillary apertures may obscure light to the retina and occlude visual axis (6,7). To reduce the risk of deprivational amblyopia for these patients, early surgical intervention should be considered (8).…”

Section: Introductionmentioning

confidence: 99%

Surgical membranectomy with modified incision and capsulotomy microscissors for persistent pupillary membrane

Nie

Zou

et al. 2021

Ann Palliat Med

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Background: To evaluate the visual outcome and complications of surgical membranectomy with modified incision and capsulotomy microscissors in patients with persistent pupillary membrane (PPM). Methods:We enrolled eight eyes with PPM in six patients and performed surgical membranectomy with modified incision located near the limbus and corresponding to the middle of the densest membrane strands.Strands near the collarette of the iris were then cut using capsulotomy microscissors and thick strands were removed with capculorhexis forceps. Complications during or after surgery were evaluated, and uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) were compared pre-and post-surgery. Results:The mean age of the patients at surgery was 9.5±3.4 years (range, 5.3 to 13.8 years). Bilateral PPMs were found in two patients, small anterior capsular cataracts not locating on the visual axis in three eyes, and deprivational amblyopia in four eyes. There were no traumatic cataracts, endophthalmitis, corneal opacities, or other complications in patients during or after modified surgical membranectomy. After a mean follow-up period of 5.8±0.4 (range, 5.0 to 6.0) months, UCVA was significantly improved from 0.23±0.14 to 0.36±0.20(P=0.026), and BCVA was also significantly improved from 0.32±0.22 pre-operatively to 0.56±0.25 post-operatively (P=0.006).Conclusions: Surgical membranectomy with modified incision and capsulotomy microscissors may be a safe approach to clear the visual axis of patients with PPM. However further treatments were needed in amblyopic eyes after surgery.

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“…The persistent pupillary membranes (PPMs) represent a common congenital ocular anomaly occurring in 95% of normal newborn babies. 3 Extensive PPMs, occluding the visual axis and resulting in reduced visual acuity, are relatively uncommon 4 and they usually appear as persistent membranes or fine iris strands along the pupil. 5 Sometimes they can get attached either to the anterior lens capsule forming a cataract or to the corneal endothelium.…”

Section: Introductionmentioning

confidence: 99%

Episodes of monocular blurring of vision during breastfeeding

Petrou

Giannopoulou

Papakonstantinou

et al. 2020

American Journal of Ophthalmology Case Reports

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Purpose To describe the occurrence of visual loss secondary to dispersion of cells deriving from an iris strand during pupil dilation in a 35-year-old woman. Observations A 35-year-old woman presented complaining of blurring in the Left Eye 15–30 minutes following breastfeeding at night hours. On clinical examination, the uncorrected visual acuity was 20/20 in both eyes and slit-lamp examination demonstrated cells in the anterior chamber (26–50 cells in field/3+ SUN working group grading) whereas the examination of the right eye was unremarkable. Dilated examination revealed a thin pigmented strand of iris in the Left Eye spanning from one edge of the iris to the other (1st to 8th h). This strand was connected at a single point to the anterior capsule of the lens and from the point of connection red blood cells flowed in a linear configuration that ended at the lower part of the anterior chamber. Conclusions and importance In this case report a patient with persistent pupillary membrane in the form of an individual iris strand connected to the anterior lens capsule presented with episodes of monocular vision loss. This occurred due to red blood cell dispersion from the iris strand during mesopic light conditions and pupil dilation while breastfeeding. To the best of our knowledge, this is the first report in the literature.

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A rare case of persistent pupillary membrane: Case-based approach and management

Cited by 15 publications

References 9 publications

Evaluation of Corneal Curvature and Astigmatism in Patients with Persistent Pupillary Membrane by Partial Coherence Interferometry Measurements

Evaluation of Corneal Curvature and Astigmatism in Patients with Persistent Pupillary Membrane by Partial Coherence Interferometry Measurements

Surgical membranectomy with modified incision and capsulotomy microscissors for persistent pupillary membrane

Episodes of monocular blurring of vision during breastfeeding

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