Myopia predicts better outcome in persistent hyperplastic primary vitreous.

Abstract

PURPOSE:

Persistent hyperplastic primary vitreous (PHPV) is a congenital disorder that presents with a spectrum of ocular anomalies, including cataracts, microphthalmia, and hyaloid vessel remnants. Severe visual loss due to secondary glaucoma and retinal detachment is common. This report evaluates the visual outcome of a variant of PHPV with myopia not associated with glaucoma.

METHODS:

The records of 23 consecutive patients with the diagnosis of PHPV (all unilateral) from October 1992 to August 1995 were reviewed. All but three patients had a cataract extraction procedure and all underwent amblyopia therapy. Eyes with a phakic myopic refractive error (Rx) or aphakic refractive correction < or = 8.5 diopters (D) in the immediate postoperative period were designated as myopic.

RESULTS:

Six patients were in the myopic group (Group 1) and 17 in were the nonmyopic group (Group 2). The mean age of diagnosis was 21.1 months in Group 1 versus 2.0 months in Group 2, with a comparable follow-up period of 36 months. The mean preoperative Rx of Group 1 was -7.78 D. The mean aphakic Rx of Group 2 was +18.29 D. Average axial length measurement determined by echography was 22.46 mm in Group 1 and 14.03 mm in Group 2. The mean corneal diameter was 11.3 mm in Group 1 vs 8.9 mm in Group 2. In Group 2, seven eyes developed retinal detachment and four developed glaucoma. These complications did not develop in Group 1 during the follow-up period. Overall functional visual acuity was better in Group 1, with a median visual acuity at final follow up of 20/160, as compared with light perception for Group 2.

CONCLUSIONS:

PHPV eyes with myopia were not detected as early as the typical PHPV eyes, primarily because of less media opacification and near-normal corneal diameters. These eyes showed a more favorable visual outcome as they were less likely to develop typical PHPV-related postoperative complications. Myopic PHPV eyes may require a different management approach.

• Authors: J C Cheung, C G Summers, T L Young
• Journal: Journal of pediatric ophthalmology and strabismus (J Pediatr Ophthalmol Strabismus) 1997 May-Jun Vol. 34 Issue 3 Pg. 170-6 ISSN: 0191-3913 [Print] United States
• PMID: 9168422 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Child, Preschool
• Eye Diseases (complications, congenital, pathology)
• Female
• Glaucoma (etiology)
• Humans
• Hyperplasia
• Infant
• Male
• Myopia (complications)
• Refractive Errors (complications)
• Retinal Detachment (etiology)
• Syndrome
• Visual Acuity
• Vitreous Body (pathology)