Atkinson C S, Brodsky M C, Hiles D A, Simon J W
Department of Ophthalmology, University of Pittsburgh, Pa.
J Pediatr Ophthalmol Strabismus. 1994 Nov-Dec;31(6):387-90. doi: 10.3928/0191-3913-19941101-09.
Four infants were referred for congenital unilateral corectopia. In each case, the abnormal position of the pupil was caused by a fibrous structure that tethered the iris pupillary margin to the peripheral cornea. No patients showed characteristics of intrauterine infection, Rieger anomaly, ectopia lentis et pupillae, or iris coloboma. Amblyopia was not present in any of the patients. Three children demonstrated progression of the corectopia in the first 6 months of life. Two who developed shallow anterior chambers were treated surgically, one with an Nd:YAG laser and the other with incisional surgery. The third was treated with medical mydriasis. All four children have had favorable visual outcomes to date. The origin of the tethering strands is unclear but may be related to incomplete regression of vessels from the embryologic vascular system. We recommend medical or surgical intervention for unilateral corectopia when the pupillary aperture is displaced peripheral to the central visual axis or when the position of the iris threatens angle structures. Prophylactic occlusion therapy may also be indicated.
四名婴儿因先天性单侧瞳孔异位前来就诊。在每例病例中，瞳孔的异常位置是由一种纤维结构导致的，该结构将虹膜瞳孔边缘与周边角膜相连。没有患者表现出宫内感染、里格尔异常、晶状体瞳孔异位或虹膜缺损的特征。所有患者均未出现弱视。三名儿童在出生后的头6个月内瞳孔异位有所进展。两名出现浅前房的儿童接受了手术治疗，一名采用钕钇铝石榴石（Nd:YAG）激光治疗，另一名采用切开手术治疗。第三名儿童接受了药物散瞳治疗。迄今为止，所有四名儿童的视力预后均良好。牵拉条索的起源尚不清楚，但可能与胚胎血管系统中血管的不完全退化有关。我们建议，当瞳孔孔径移位到中央视轴以外或虹膜位置威胁到房角结构时，对单侧瞳孔异位进行药物或手术干预。也可能需要进行预防性遮盖治疗。
