Long-term clinical course and visual outcome associated with Peters’ anomaly

Jw, Chang; Kim, Jae‐Hun; Sj, Kim; Ys, Yu

doi:10.1038/eye.2012.128

Cited by 26 publications

(24 citation statements)

References 19 publications

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“…Overall, our findings suggest that it is rare to obtain a VA of at least 20/40 or higher, affirming the outcomes of previous reports on this patient population. 4–6 , 8 , 9 In a cohort of 76 patients with differing severity of corneal opacification reported by Chang et al 10 the average final VA of patients with PA was 2.049±0.965 logMAR (20/2240). No difference was found between unilateral (2.05±0.97 log MAR) and bilateral (2.05±0.97 logMAR) cases, despite medical and/or surgical interventions.…”

Section: Discussionmentioning

confidence: 92%

Visual Outcomes in Pediatric Patients with Peters Anomaly

Fouzdar-Jain

Ibrahim

Reitinger

et al. 2021

OPTH

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Purpose This study aimed to evaluate the visual outcomes of pediatric patients diagnosed with Peters anomaly (PA) in a tertiary eye care center. Methods This was a retrospective study undertaken at a single academic center. Clinical records of pediatric patients diagnosed with PA from 2000 to 2017 were reviewed. Parameters recorded included visual acuity (VA), intraocular pressure (IOP), presence of glaucoma, and surgical procedures performed. The impact of PA type on final visual acuity levels was analyzed using generalized estimation equation models. Results Twenty-one eyes from 11 patients were analyzed. At the final visit, 9 eyes (42.8%) had a VA ≥20/200, while 12 (57%) had <20/200, ranging from 20/250 to no light perception. Of the study cohort, 15 (71.5%) eyes had type I, while six (28.5%) had type II PA. Glaucoma was present in 20 eyes (95%) at the final visit. One eye had dense central leucoma and microphthalmos where IOP could not be measured accurately. Seventeen eyes (81%) underwent at least one intraocular surgery, while the average number of surgeries per eye was 2.9 ± 2.5 (range=0– 9). The type of PA beta(se)=0.53 (0.41), p = 0.20] was not found to be a significant risk factor for worse VA. Conclusion Severe visual impairment develops in the majority of patients with PA. The type of anomaly does not appear to be associated with a worse visual function in patients with PA. Glaucoma develops in a high percentage of this patient population, and thus close monitoring of IOP in this patient population is crucial.

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Section: Discussionmentioning

confidence: 92%

Visual Outcomes in Pediatric Patients with Peters Anomaly

Fouzdar-Jain

Ibrahim

Reitinger

et al. 2021

OPTH

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“…Visual deprivation during the early stages of life as a result of congenital corneal opacities can result in long‐term changes to the central nervous system unless corrected prior to 3‐6 months of age 8 . PKP has a significantly higher success rate in adults vs children, with the success rate being lowest for congenital corneal opacities 9 . An elastic cornea, scleral collapse, and anterior movement of the lens make PKP more challenging in infants.…”

Section: Discussionmentioning

confidence: 99%

“…Visual prognosis is dependent on disease severity. Although there is no formal classification for disease severity in Peters anomaly, Chang et al 9 defined patients with severe disease as being characterized by dense central opacities covering more than half of the cornea, corneolenticular adhesions, or associated ophthalmic anomalies like microphthalmia, aniridia, or cataracts. Patients with mild disease characterized by corneal opacities covering less than half of the cornea and visual acuities of 20/100 or more had better visual outcomes with treatment.…”

Section: Discussionmentioning

confidence: 99%

Peters anomaly: A 5‐year experience

Salik

Gupta

Tara

et al. 2020

Pediatric Anesthesia

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Background Peters anomaly is a rare, congenital eye malformation characterized by an opaque cornea and blurred vision. Central corneal opacification can lead to delayed progression of visual development caused by defects in Descemet membrane and the posterior stroma. These children require several anesthetics for multiple eye examinations under anesthesia and corneal transplantation. Aims We sought to review the anesthetic management of patients with Peters anomaly for ophthalmologic procedures at Westchester Medical Center, a major referral center for Peters anomaly. Methods A retrospective chart review was completed which included pediatric patients who underwent ophthalmologic procedures related to Peters anomaly from 2013‐2018. Results The charts of 35 patients with Peters anomaly were reviewed: 14 patients with Peters anomaly Type I, 10 patients with Peters anomaly Type II, and 11 patients with Peters plus syndrome. Thirty patients required three procedures on average, two examinations under anesthesia pre‐ and post‐transplant, and anesthesia for the corneal transplant itself. The youngest patient encountered for examination under anesthesia was 39‐week postconceptual age. Anesthetic time for examination under anesthesia averaged 31 minutes using a laryngeal mask airway while corneal transplant averaged 104 minutes utilizing endotracheal intubation. Postanesthesia care unit stay averaged 51 minutes following examination under anesthesia and 65 minutes after corneal transplant. All examinations under anesthesia were successfully completed without adverse events with the use of a laryngeal mask airway. This case series includes two patients with Goldenhar syndrome and Al‐Gazali syndrome accompanying Peters anomaly. Conclusion Although limited by its retrospective nature, this case series describes the cardiac and systemic implications of patients undergoing anesthesia with Peters anomaly. Our experience indicates that general anesthesia and airway manipulation are tolerated with minor postoperative concerns in these infants. Pediatric patients with Peters anomaly require multiple anesthetics for repeated ophthalmologic interventions. The laryngeal mask airway can be routinely utilized in infants less than 3 months of age for an eye examination under anesthesia with no airway complications noted. Perioperative providers should be aware of the multisystemic implications in patients with Peters plus syndrome.

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“…A later diagnosis recommends that patients undergo molecular genetic testing and receive consults from retina, cornea, and glaucoma specialists. Guidelines recommend the initiation of treatment as early as possible in order to prevent sensory amblyopia 11. While Dorzolamide is available to treat pediatric glaucoma, early surgical intervention is strongly advised 12–15.…”

Section: Short Reportmentioning

confidence: 99%

“…Guidelines recommend the initiation of treatment as early as possible in order to prevent sensory amblyopia. 11 While Dorzolamide is available to treat pediatric glaucoma, early surgical intervention is strongly advised. [12][13][14][15] In a patient presenting with a clear peripheral cornea, peripheral iridectomy is the treatment of choice.…”

Section: Short Reportmentioning

confidence: 99%