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. 2025 Feb 7;45(1):63.
doi: 10.1007/s10792-025-03436-2.

Manifestations of persistent pupillary membrane

N F Bobrova  1 , T V Romanova  2 , O D Dovhan  2 , N I Molchaniuk  3
Affiliations

Manifestations of persistent pupillary membrane

N F Bobrova et al. Int Ophthalmol. .

Abstract

Purpose: To study the clinical and structural manifestations of persistent pupillary membranes (PPM) using light and electron microscopy.

Materials and methods: This descriptive case series study included 32 children (38 eyes) with different clinical PPM types. The cases were collected between 2005 and 2023. The age of the patients ranged from 7 months to 13 years, with a mean age of 3 ± 2.6 years. All children underwent standard ophthalmological examinations, including biomicroscopy, keratometry, gonioscopy, ophthalmoscopy, tonometry, visometry, ultrasonic biometry, scanning, and photo and video recording. Surgical removal of PPM was performed in 15 children (17 eyes), and the removed PPMs were histologically and electron microscopically studied.

Results: The PPMs were of different sizes, configurations, and volumes. The vast majority, 25 children (29 eyes, 76.3%), had type II PPM with iridolenticular attachment (Duke-Elder classification, 1964). Six children (8 eyes, 21.1%) had type I PPMs with iris-to-iris attachment. In one case (one eye, 2.67%), a combination of type I and type II PPM was observed. In the eyes with PPM, microphthalmia and microcornea were observed in 34.2% and 23.7% of cases, respectively. PPM affected the size and configuration of the pupil in 44.76% of cases and the anterior chamber angle structure in 26.3% of cases. The lens remained transparent in 84.2% of the cases. Congenital cataracts were observed in 15.89%. Visual acuity in the eyes with PPM varied from light perception to 0.4 logMAR. In 50.0% of cases, significant visual loss occurred in type II PPM. Histomorphological and electron microscopic studies showed that PPM was the remnant of the tunica vasculosa lentis, had a mesodermal origin, and did not penetrate the anterior lens capsule.

Conclusion: For the first time, the clinical features of PPM were analyzed in a significantly large number of cases, and the analysis showed that PPMs with iridolenticular attachment were dominant. They were of different sizes and configurations and had a dense fit to the lens, causing significant visual loss and thus requiring surgical removal. In almost half of the cases, PPM caused pupil narrowing, decentration, and deformation, whereas the crystalline lens remained transparent in most cases (84.2%).

Keywords: Congenital cataract; Persistent pupillary membrane; Pupil size and configuration.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no relevant financial or non-financial interests. Ethical approval: The study was conducted with human subjects and was approved by the Bioethics committee of the Filatov Institute. This study was conducted in accordance with the Declaration of Helsinki. Animals were not included in this study. Consent to participate: Informed consent was obtained from the parents of all study participants.

References

    1. Brueckner A (1907) Ueber Persistenz von Resten der tunica vasculosa lentis. Arch Fur Augenheilk 56:5–149
    1. Duke-Elder S (1964) System of ophthalmology. Henry Kimpton, London, pp 587–775
    1. Kapoor K, Baratz K, Barkmeier A (2013) Laser photocoagulation of an avulsed persistent pupillary membrane vessel causing recurrent hyphema. Clin Experiment Ophtalmol 41:513–515 - DOI
    1. Bhatti SM, Kapoor HK (1998) Bilateral accessory iris membrane. Indian J Ophthalmol 46(2):110–111 - PubMed
    1. Bobrova NF, Vit VV (2006) [Atlas of congenital and hereditary diseases of the eye]. Odessa, Palmira. in Russian

Supplementary concepts