近视预示着持续性增生性原发性玻璃体病变有更好的预后。

Myopia predicts better outcome in persistent hyperplastic primary vitreous.

作者信息

Cheung J C, Summers C G, Young T L

机构信息

Department of Ophthalmology, University of Minnesota, Minneapolis 55455, USA.

出版信息

J Pediatr Ophthalmol Strabismus. 1997 May-Jun;34(3):170-6. doi: 10.3928/0191-3913-19970501-08.

DOI:10.3928/0191-3913-19970501-08

PMID:9168422

Abstract

PURPOSE

Persistent hyperplastic primary vitreous (PHPV) is a congenital disorder that presents with a spectrum of ocular anomalies, including cataracts, microphthalmia, and hyaloid vessel remnants. Severe visual loss due to secondary glaucoma and retinal detachment is common. This report evaluates the visual outcome of a variant of PHPV with myopia not associated with glaucoma.

METHODS

The records of 23 consecutive patients with the diagnosis of PHPV (all unilateral) from October 1992 to August 1995 were reviewed. All but three patients had a cataract extraction procedure and all underwent amblyopia therapy. Eyes with a phakic myopic refractive error (Rx) or aphakic refractive correction < or = 8.5 diopters (D) in the immediate postoperative period were designated as myopic.

RESULTS

Six patients were in the myopic group (Group 1) and 17 in were the nonmyopic group (Group 2). The mean age of diagnosis was 21.1 months in Group 1 versus 2.0 months in Group 2, with a comparable follow-up period of 36 months. The mean preoperative Rx of Group 1 was -7.78 D. The mean aphakic Rx of Group 2 was +18.29 D. Average axial length measurement determined by echography was 22.46 mm in Group 1 and 14.03 mm in Group 2. The mean corneal diameter was 11.3 mm in Group 1 vs 8.9 mm in Group 2. In Group 2, seven eyes developed retinal detachment and four developed glaucoma. These complications did not develop in Group 1 during the follow-up period. Overall functional visual acuity was better in Group 1, with a median visual acuity at final follow up of 20/160, as compared with light perception for Group 2.

CONCLUSIONS

PHPV eyes with myopia were not detected as early as the typical PHPV eyes, primarily because of less media opacification and near-normal corneal diameters. These eyes showed a more favorable visual outcome as they were less likely to develop typical PHPV-related postoperative complications. Myopic PHPV eyes may require a different management approach.

摘要

目的

永存原始玻璃体增生症（PHPV）是一种先天性疾病，表现为一系列眼部异常，包括白内障、小眼症和玻璃体血管残余。继发于青光眼和视网膜脱离导致的严重视力丧失很常见。本报告评估了一种不伴有青光眼的近视性PHPV变体的视力预后。

方法

回顾了1992年10月至1995年8月连续诊断为PHPV（均为单侧）的23例患者的病历。除3例患者外，所有患者均接受了白内障摘除手术，且均接受了弱视治疗。术后即刻有晶状体近视屈光不正（Rx）或无晶状体屈光矫正≤8.5屈光度（D）的眼被指定为近视性眼。

结果

6例患者属于近视组（第1组），17例属于非近视组（第2组）。第1组的平均诊断年龄为21.1个月，而第2组为2.0个月，随访期相当，均为36个月。第1组术前平均Rx为-7.78 D。第2组无晶状体平均Rx为+18.29 D。通过超声检查确定的平均眼轴长度在第1组为22.46 mm，在第2组为14.03 mm。第1组平均角膜直径为11.3 mm，第2组为8.9 mm。在第2组中，7只眼发生了视网膜脱离，4只眼发生了青光眼。在随访期间，第1组未发生这些并发症。总体功能视力在第1组更好，最后随访时的中位视力为20/160，而第2组为光感。