Yoshikawa Haruna, Sotozono Chie, Ikeda Yoko, Mori Kazuhiko, Ueno Morio, Kinoshita Shigeru
Departments of *Ophthalmology; and †Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Cornea. 2017 Apr;36(4):448-451. doi: 10.1097/ICO.0000000000001161.
Peters anomaly (PA) is known to be a primary cause of congenital corneal opacity. The aim of this study is to report the long-term clinical course and visual achievement of patients with PA who did not undergo keratoplasty.
This retrospective study involved 15 eyes of 9 infants with PA less than 5 months of age at initial presentation at the Kyoto Prefectural University of Medicine who were followed up without keratoplasty for more than 6 years after presentation. In each subject, visual acuity, intraocular pressure (IOP), presence of congenital glaucoma, and change of corneal opacity were retrospectively investigated.
At initial presentation, the mean patient age was 2.3 months (SD: 1.3; range: 0-4 mo), and the mean follow-up period was 7.9 years (SD: 1.8; range: 6.5-11.3 yrs). Of the 9 patients, 6 were affected bilaterally. Thirteen eyes of 7 patients were found to have glaucoma. Over the follow-up period, corneal opacity gradually decreased in 4 eyes, 1 eye each of 2 unilateral patients without glaucoma and both eyes of 1 bilaterally affected patient with good IOP control during the follow-up period. Visual acuity in the unilateral case with intensive amblyopia treatment gradually increased along with decreasing corneal opacity.
The findings of this study show that a natural decrease of corneal opacity can occur in eyes with PA. In cases of unilateral PA without IOP elevation and no enlargement of the corneal diameter, strict amblyopia treatment is vital to obtain a favorable visual prognosis.
彼得斯异常(PA)是先天性角膜混浊的主要原因。本研究旨在报告未接受角膜移植术的PA患者的长期临床病程和视觉预后。
本回顾性研究纳入了9例婴儿的15只眼,这些婴儿在京都府立医科大学初次就诊时年龄小于5个月,就诊后未接受角膜移植术,随访时间超过6年。对每个受试者的视力、眼压(IOP)、先天性青光眼的存在情况以及角膜混浊的变化进行回顾性调查。
初次就诊时,患者的平均年龄为2.3个月(标准差:1.3;范围:0 - 4个月),平均随访时间为7.9年(标准差:1.8;范围:6.5 - 11.3年)。9例患者中,6例为双眼受累。7例患者的13只眼被发现患有青光眼。在随访期间,4只眼的角膜混浊逐渐减轻,其中2例单侧无青光眼患者各有1只眼,1例双侧受累患者在随访期间眼压控制良好,其双眼角膜混浊减轻。单侧病例经过强化弱视治疗后,视力随着角膜混浊减轻而逐渐提高。
本研究结果表明,PA患者的眼睛角膜混浊可自然减轻。对于单侧PA且眼压未升高、角膜直径未增大的病例,严格的弱视治疗对于获得良好的视觉预后至关重要。