Al Otaibi Abdullah, AlShamrani Mohammed, Alarfaj Ghufran, Alsalman Budoor, Neyaz Hanan A, Alkatan Hind M
Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Int J Surg Case Rep. 2023 Jul;108:108452. doi: 10.1016/j.ijscr.2023.108452. Epub 2023 Jun 30.
Congenital fibrovascular pupillary membranes (CFPMs) represent a rare poorly understood condition that has been sporadically reported in the literature. The presence of such a membrane can cause pupillary block and further complications, therefore must be properly diagnosed and managed.
We are presenting the successful treatment of 2 cases with CFPM. The first patient presented 2-days after birth with an absent red reflex and had a less complicated clinical course. The second presented at a later age of 5-months and was referred as a case of congenital cataract. This baby had associated pupillary block glaucoma. Each of these cases was managed surgically by membrane peeling with sparing of the lens, which was found to be clear in the second case.
Even though CFPM has been rarely reported, it should be correctly identified since it can progress with the development of glaucoma and lens changes. The etiology of CFPM is not well understood but might be related to the presence of ectopic iris tissue, which was suspected as an etiology in our second case. Several techniques have been described to remove the membrane, and occasionally this might necessitate removal of the lens. We described successful removal of CFPM in 2 cases without affecting the crystalline lens.
General Ophthalmologists and Pediatricians should be aware of CFPM, especially when dealing with an absent or dull red reflex in a newborn. Referral for definitive diagnosis and treatment is essential to preserve vision.
先天性纤维血管性瞳孔膜（CFPMs）是一种罕见且了解甚少的病症，文献中仅有零星报道。这种膜的存在可导致瞳孔阻滞及进一步的并发症，因此必须进行正确诊断和处理。
我们报告了2例CFPM的成功治疗案例。首例患者出生后2天就诊，表现为无红光反射，临床病程相对简单。第二例患者5个月大时就诊，被诊断为先天性白内障。该患儿伴有瞳孔阻滞性青光眼。每例患者均通过保留晶状体的膜剥除术进行手术治疗，第二例患者的晶状体检查显示清晰。
尽管CFPM的报道较少，但由于其可随青光眼和晶状体变化而进展，故应正确识别。CFPM的病因尚不清楚，但可能与异位虹膜组织的存在有关，我们的第二例病例即怀疑为此病因。已有多种去除该膜的技术被描述，有时可能需要摘除晶状体。我们成功地在2例患者中去除了CFPM，且未影响晶状体。
普通眼科医生和儿科医生应了解CFPM，尤其是在处理新生儿无红光反射或红光反射暗淡的情况时。转诊以进行明确诊断和治疗对于保护视力至关重要。
