Shao Zheng, Xie Feijia, Huang Yusen
J Pediatr Ophthalmol Strabismus. 2025 Jul-Aug;62(4):286-296. doi: 10.3928/01913913-20250227-06. Epub 2025 Mar 26.
To retrospectively analyze the clinical characteristics and therapeutic outcomes of congenital fibrovascular pupillary membrane (CFPM).
Twelve children (13 eyes) diagnosed as having CFPM between November 2017 and January 2024 in Qingdao Eye Hospital were retrospectively reviewed. Basic information and ophthalmic examination results were analyzed. Different treatment outcomes were monitored. Pathological analysis was performed using hematoxylin-eosin staining.
Three eyes (25%) received conservative treatment, whereas 10 eyes (83.3%) underwent membranectomy. Compared to fellow eyes, the affected eyes exhibited increased central corneal and lens thickness, with decreased central anterior chamber depth (all < .05). No significant difference was observed in mean preoperative intraocular pressure between the affected and fellow eyes, both within normal range. The median best corrected visual acuity (BCVA) for non-surgical cases was 0.9 llogarithm of the minimum angle of resolution (og-MAR) (Snellen equivalent of 0.125) with miosis. Surgical treatment improved the natural pupil size and median BCVA to 0.4 logMAR (Snellen equivalent of 0.4). Postoperative amblyopia was 100% and 33.3% in patients who underwent surgery after age 3 years and at or before 3 years, respectively ( = .035). No surgery-induced cataracts or recurrence in cases of unilateral involvement was noted. Histopathological analysis revealed that the excised tissue consisted of proliferative fibrous and vascular tissues with infiltrated inflammatory cells.
Affected eyes in CFPM exhibit a thickened cornea and lens with a shallow anterior chamber, typically without glaucoma. Surgery is a safe and effective treatment with low recurrence and fewer complications compared to limited conservative treatment. Performing surgery before age 3 years reduces amblyopia risk. CFPM may be linked to chronic inflammation from incomplete degeneration of fetal eye vasculature. .
回顾性分析先天性纤维血管性瞳孔膜（CFPM）的临床特征及治疗效果。
回顾性分析2017年11月至2024年1月在青岛眼科医院确诊为CFPM的12例儿童（13只眼）。分析其基本信息及眼科检查结果，监测不同治疗效果。采用苏木精-伊红染色进行病理分析。
3只眼（25%）接受保守治疗，10只眼（83.3%）接受膜切除术。与对侧眼相比，患眼中央角膜和晶状体厚度增加，中央前房深度减小（均P<0.05）。患眼与对侧眼术前平均眼压无显著差异，均在正常范围内。非手术病例的最佳矫正视力（BCVA）中位数为0.9最小分辨角对数（log-MAR）（Snellen视力相当于0.125）伴瞳孔缩小。手术治疗使自然瞳孔大小及BCVA中位数提高至0.4 logMAR（Snellen视力相当于0.4）。3岁后及3岁及以前接受手术的患者术后弱视发生率分别为100%和33.3%（P=0.035）。未发现手术引起的白内障或单侧受累病例复发。组织病理学分析显示，切除组织由增生的纤维和血管组织以及浸润的炎症细胞组成。
CFPM患眼表现为角膜和晶状体增厚，前房浅，通常无青光眼。与有限的保守治疗相比，手术是一种安全有效的治疗方法，复发率低且并发症少。3岁前进行手术可降低弱视风险。CFPM可能与胎儿眼部血管系统不完全退化导致的慢性炎症有关。
