Zhu Yingting, Fang Lei, Zhong Yimin, Oatts Julius, Han Ying, Lin Shufen, Chen Liming, Zhou Xiaodi, Su Yihua, Liu Pingping, Liu Xing
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Department of Ophthalmology, School of Medicine, University of California, San Francisco, San Francisco, CA, United States.
Front Med (Lausanne). 2021 Oct 28;8:763137. doi: 10.3389/fmed.2021.763137. eCollection 2021.
The purpose of this study was to describe and summarize the clinical features of congenital fibrovascular pupillary membrane-induced secondary glaucoma (CFPMSG). Cross-sectional case series. Eyes of 32 patients with CFPMSG were enrolled. Demographic data, including gender, laterality, age at presentation, and age at onset of glaucoma were collected. Patients underwent comprehensive ophthalmic examinations and ultrasound biomicroscopy (UBM). CFPMSG eyes were classified into three groups based on UBM findings and intergroup analysis was performed using ANOVA. The average age at presentation was 2.4 ± 4.6 months (mean ± SD) and at glaucoma onset was 3.8 ± 4.5 months. Compared to normal fellow eyes, all affected eyes had increased intraocular pressure (IOP), axial length, corneal diameter, and central corneal thickness, and decreased anterior chamber depth (ACD) (all ≤ 0.001). Twenty-two affected eyes (68.8%) had evidence of glaucomatous optic neuropathy. Based on iris configuration on UBM, eyes were classified as 53% type I ("U" shape), 34% type II ("Y" shape), and 13% type III (no anterior chamber). IOP in types II (33.8 ± 5.9 mmHg) and III (35.2 ± 5.9 mmHg) was significantly higher than in type I eyes (26.5 ± 5.1 mmHg). The ACD was shallower in type II compared to type I ( = 0.045). Congenital fibrovascular pupillary membrane-induced secondary glaucoma is characterized by ocular hypertension, corneal enlargement and edema, axial length elongation, and glaucomatous optic neuropathy. Glaucoma in this condition is secondary to pupillary block and angle-closure. UBM provides important information for the diagnosis and classification of CFPMSG. This novel classification system demonstrated varying levels of severity and may guide on management of this disease.
本研究的目的是描述和总结先天性纤维血管性瞳孔膜引起的继发性青光眼（CFPMSG）的临床特征。横断面病例系列研究。纳入了32例CFPMSG患者的眼睛。收集了人口统计学数据，包括性别、患侧、就诊年龄和青光眼发病年龄。患者接受了全面的眼科检查和超声生物显微镜检查（UBM）。根据UBM检查结果，将CFPMSG患眼分为三组，并采用方差分析进行组间分析。就诊时的平均年龄为2.4±4.6个月（均值±标准差），青光眼发病时的平均年龄为3.8±4.5个月。与对侧正常眼相比，所有患眼的眼压、眼轴长度、角膜直径和中央角膜厚度均增加，前房深度（ACD）减小（均P≤0.001）。22只患眼（68.8%）有青光眼性视神经病变的证据。根据UBM上的虹膜形态，患眼分为I型（“U”形）占53%，II型（“Y”形）占34%，III型（无前房）占13%。II型（33.8±5.9 mmHg）和III型（35.2±5.9 mmHg）患眼的眼压显著高于I型患眼（26.5±5.1 mmHg）。II型患眼的ACD比I型患眼更浅（P=0.045）。先天性纤维血管性瞳孔膜引起的继发性青光眼的特征为高眼压、角膜增大和水肿、眼轴长度延长以及青光眼性视神经病变。这种情况下的青光眼继发于瞳孔阻滞和房角关闭。UBM为CFPMSG的诊断和分类提供了重要信息。这种新的分类系统显示了不同程度的严重程度，可能有助于指导该病的治疗。
