Persistent Hyperplastic Primary Vitreous

持续性增生性原发性玻璃体
  • 文章类型: Case Reports
    持续性胎儿脉管系统(PFV),或持续性增生性原发性玻璃体(PHPV),是一种先天性发育障碍,其特征是玻璃样系统的吸收失败。它通常单侧出现,有三种形式:前,后部,和混合。在这个案例报告中,一个七岁的病人,没有特定的个人或家族病史,从儿科转诊为双侧乳头水肿。患者双眼的最佳矫正视力为20/20(分辨率角度的对数测量(LogMAR):0)。双眼眼底检查显示充血的假乳头水肿,短,mobile,从视盘向玻璃体腔延伸的褐色带。双眼眼部超声显示视神经头部有一条细小的高回声线,和乳头状光学相干断层扫描(OCT)显示乳头状牵引综合征。确定了乳头牵引的持续性胎儿血管的后部和双侧形式的诊断。
    Persistent fetal vasculature (PFV), or persistent hyperplastic primary vitreous (PHPV), is a congenital developmental disorder characterized by a failure of resorption of the hyaloid system. It typically presents unilaterally and has three forms: anterior, posterior, and mixed. In this case report, a seven-year-old patient, without specific personal or family medical history, was referred from the pediatric department for bilateral papilledema. The patient had a best-corrected visual acuity of 20/20 (Logarithmic Measure of Angle of Resolution (LogMAR): 0) in both eyes. Fundus examination of both eyes revealed congested pseudopapilledema with a short, mobile, brownish band extending from the optic disc towards the vitreous cavity. Ocular ultrasound of both eyes showed a fine hyperechoic line pulling on the optic nerve head, and papillary optical coherence tomography (OCT) showed a papillary traction syndrome. The diagnosis of a posterior and bilateral form of persistent fetal vasculature with papillary traction was established.
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  • 文章类型: Journal Article
    此病例报告讨论了一名50岁男孩的持续性增生性原发性玻璃体表现为白细胞增多症的诊断。
    This case report discusses a diagnosis of persistent hyperplastic primary vitreous presenting as leukocoria in a boy aged 50 days.
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  • 文章类型: Case Reports
    持续的胎儿脉管系统是一系列与胎儿眼部脉管系统的不完全消退有关的眼部异常。一名21岁的男性患者从3岁开始来到门诊,报告左眼视力低下和斜视。眼科检查显示右眼正常,而左眼的手动作知觉矫正视力最好,30棱镜屈光度内斜视,“珊瑚状”白内障和玻璃茎连接晶状体和视神经的后表面。珊瑚状白内障具有纺锤形的突起,沿轴向从其中心向外辐射,并位于后囊膜下区域。由于视力预后不良,患者选择不接受玻璃体视网膜手术。所描述的患者中存在的异常白内障可能与他的未治疗状态有关,正如以前的作者所报道的那样,在持续性胎儿脉管系统中未经治疗的白内障可能会发生不同的变性。
    Persistent fetal vasculature is a spectrum of ocular abnormalities linked to an incomplete regression of the fetal ocular vasculature. A 21-years old male patient came to the outpatient clinic reporting low vision and strabismus in his left eye since 3 years of age. Ophtalmological examination revealed a normal right eye, while the left eye had a best corrected visual acuity of hand-motion perception, a 30 prism diopters esotropia, a \"coralliform\" cataract and a vitreous stalk joining the posterior face of the lens and the optic nerve. The coralliform cataract possessed spindle-shaped processes radiating out of its center in an axial direction and was located in the posterior subcapsular area. The patient elected to not undergo vitreoretinal surgery due to the poor visual prognosis. The unusual cataract present in the described patient could be related to his untreated status, as previous authors have reported that untreated cataracts in persistent fetal vasculature may undergo diverse degenerations.
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  • 文章类型: Case Reports
    我们介绍了一例眼眶原发性横纹肌样肿瘤。出生时呈现的特征包括先天性上睑下垂,结膜注射,充血和小眼症。在6个月后发生快速突增后,这种独特的表现导致了晚期诊断。我们建议在具有非典型持续性胎儿血管特征的患者的鉴别诊断中考虑眶横纹肌肿瘤。
    We present a case of primary rhabdoid tumour of the orbit. Presenting features at birth included congenital ptosis, conjunctival injection, hyphaema and microphthalmia. The unique presentation caused a late diagnosis following the development of rapid proptosis 6 months later. We suggest that orbital rhabdoid tumour be considered in the differential diagnoses of patients presenting with atypical persistent foetal vasculature features.
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  • 文章类型: Case Reports
    持续性增生性原发性玻璃体(PHPV)是一种罕见的先天性发育性眼部疾病,由胚胎玻璃样脉管系统的不完全消退引起;双侧表现甚至更罕见。我们报告了一名6岁的双侧PHPV儿童,他因斜视来我院就诊,没有表现出白血病,小眼症,和系统性疾病。这些独特的特征将我们的案例与其他PHPV案例区分开来。提高对儿童先天性眼病的认识以及扩大瞳孔进行眼底检查的重要性至关重要。
    Persistent hyperplastic primary vitreous (PHPV) is a rare congenital developmental ocular disorder caused by incomplete regression of the embryonic hyaloid vasculature; bilateral presentations are even rarer. We report a 6-year-old child with bilateral PHPV who visited our hospital for strabismus, without exhibiting leukocoria, microphthalmia, and systemic diseases. These unique characteristics distinguish our case from other cases of PHPV. It is crucial to increase awareness of congenital eye disease in children and the importance of performing fundus examination with the pupils dilated.
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  • 文章类型: Case Reports
    背景:巨脑症-多趾-脑积水(MPPH)综合征是一种罕见的常染色体显性疾病,以巨脑症(即脑过度生长)为特征,大脑皮层和多指的多囊和局灶性发育不全。持续性增生性原发性玻璃体(PHPV)涉及一系列先天性眼部异常,其特征在于晶状体后面存在血管膜。
    方法:这里,我们介绍了一例使用产前超声诊断的胎儿MPPH伴PHPV的病例。超声波显示巨脑症的存在,多发性小脑回和脑积水。全外显子组测序证实了AKT3基因的突变,这导致了对MPPH综合征的考虑。此外,在晶状体和左眼后壁之间观察到不规则表面的回声带;因此,怀疑有PHPV的MPPH。
    结论:MPPH综合征伴PHPV可在产前诊断。
    BACKGROUND: Megalencephaly-polymicrogyria-polydactyly-hydrocephalus (MPPH) syndrome is a rare autosomal dominant disorder characterized by megalencephaly (i.e., overgrowth of the brain), polymicrogyria, focal hypoplasia of the cerebral cortex, and polydactyly. Persistent hyperplastic primary vitreous (PHPV) involves a spectrum of congenital ocular abnormalities that are characterized by the presence of a vascular membrane behind the lens.
    METHODS: Here, we present a case of foetal MPPH with PHPV that was diagnosed using prenatal ultrasound. Ultrasound revealed the presence of megalencephaly, multiple cerebellar gyri, and hydrocephalus. Whole-exome sequencing confirmed the mutation of the AKT3 gene, which led to the consideration of MPPH syndrome. Moreover, an echogenic band with an irregular surface was observed between the lens and the posterior wall of the left eye; therefore, MPPH with PHPV was suspected.
    CONCLUSIONS: MPPH syndrome with PHPV can be diagnosed prenatally.
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  • 文章类型: Journal Article
    目的:研究Bergmeister乳头(BMP)的形态特征,持久的玻璃样残余组织,及其对谱域光学相干断层扫描(OCT)的测量和可重复性的影响。
    方法:这项前瞻性横断面研究的受试者包括83例BMP患者和76例未受影响的个体,都有开角结构。Images,包括一个5线光栅和三个以光盘为中心的连续光盘立方体扫描,是使用Cirrus高清OCT获得的。基于光栅扫描图像对BMP的结构特征进行了分类,通过计算重测标准偏差(Sw)分析获取视神经乳头和视网膜神经纤维层参数的可重复性,变异系数(CV),和组内相关系数。
    结果:BMP(n=83)被归类为提升边缘(LE)类型(63.9%,n=53),部分覆盖了视神经头的边缘,和覆盖光盘(CD)类型(36.1%,n=30),像帽子一样完全覆盖了拔罐区域。平均杯盘比(0.58±0.21),垂直杯盘比(0.55±0.21),CD型和杯容积(0.22±0.22)低于LE型(分别为0.66±0.13、0.64±0.13和0.4±0.27;均P<0.05)。LE型BMP中杯容量(Sw=0.40和CV=0.36)和鼻下(4点)视网膜神经纤维层(Sw=0.27和CV=0.25)的可重复性的耐受性指数超过了临界值(0.22),并且与BMP位置的相关性比对照更强。
    结论:在使用BMP解释眼睛的OCT发现时应谨慎,因为BMP会在OCT成像中引入缺陷。
    OBJECTIVE: To investigate the morphological characteristics of Bergmeister papilla (BMP), a persistent hyaloid remnant tissue, and its effects on the measurements and repeatability of spectral-domain optical coherence tomography (OCT).
    METHODS: The subjects of this prospective cross-sectional study including 83 patients with BMP and 76 unaffected individuals, all had open-angle structures. Images, including a 5-line raster and three consecutive optic disc cube scans centred on the optic disc, were acquired using the Cirrus high-definition OCT. BMP\'s structural characteristics were classified based on the raster scan images, and repeatability of acquiring optic nerve head and retinal nerve fibre layer parameters acquisition was analysed by calculating the test-retest standard deviation (Sw), coefficient of variance (CV), and intraclass correlation coefficient.
    RESULTS: BMPs (n = 83) were categorised into lifting edge (LE) type (63.9%, n = 53), which partially covers the edge of the optic nerve head, and covering disc (CD) type (36.1%, n = 30), which completely covers the cupping area like a cap. The average cup-to-disc ratio (0.58 ± 0.21), vertical cup-to-disc ratio (0.55 ± 0.21), and cup volume (0.22 ± 0.22) of the CD type were lower than those of the LE type (0.66 ± 0.13, 0.64 ± 0.13, and 0.4 ± 0.27, respectively; all P < 0.05). Tolerability indices for repeatability of cup volume (Sw = 0.40 and CV = 0.36) and inferonasal (4 o\'clock) retinal nerve fibre layer (Sw = 0.27 and CV = 0.25) in LE-type BMPs exceeded the cut-off value (0.22) and demonstrated stronger correlation with BMP location than that of the controls.
    CONCLUSIONS: Caution should be exercised when interpreting OCT findings in eyes with BMP, as BMP can introduce a pitfall in OCT imaging.
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  • 文章类型: Journal Article
    目的:报告持续性胎儿血管(PFV)相关白内障手术后5年的结局。
    方法:使用每年从医疗记录中收集的儿童白内障登记数据进行临床队列研究。
    方法:64名13岁以下儿童,接受单侧手术,包括与PFV相关的非创伤性白内障。估计了5年随访时年龄正常视力(VA)和VA优于20/200的比例。计算5年的并发症和额外手术的累积发生率。从我们的注册表中比较了单侧PFV和单侧非PFV白内障的结果。
    结果:64只眼中的48只眼术后无晶状体(手术时的中位年龄为2个月,范围1-13)和16是假晶状体(29个月,范围2到92)。总的来说,42只眼睛中的4只(10%,95%CI:3%-23%)达到年龄正常视力。VA优于20/200在17个(59%,95%CI39%-76%)单侧无晶状体PFV眼和44(43%,95%CI32%-54%)单侧非PFV无晶状体眼(年龄校正OR=1.90;95%CI:0.81-4.50;P=0.14)。无晶状体PFV眼最常见的并发症是青光眼相关不良事件(GRAE)(累积发生率24%,95%CI:9%-37%)。在晶状体切除术中年龄≤1岁的无晶状体参与者中,PFV和非PFV眼之间的GRAE没有显着差异(年龄调整后的HR=1.20,95%CI:0.54-2.64,P=0.66)。
    结论:观察到PFV白内障的视觉结果广泛,达到年龄正常VA的概率为10%。在PFV眼中存在发展青光眼相关不良事件的持续风险。
    我们研究了64例接受单侧手术的儿童的结局,与持续的胎儿血管系统相关的非创伤性白内障;48例左侧无晶状体,16例假晶状体。观察到持续性胎儿脉管系统白内障的视觉结果范围,达到年龄正常VA的概率为10%。无晶状体眼青光眼相关不良事件累积发生率为24%,这与没有持续性胎儿脉管系统的对照组相似。
    OBJECTIVE: To report 5-year outcomes after surgery for cataract associated with persistent fetal vasculature (PFV).
    METHODS: Clinical cohort study using pediatric cataract registry data collected annually from medical records.
    METHODS: This study included 64 children <13 years of age who were undergoing surgery for unilateral, nontraumatic cataract associated with PFV. Proportions with age-normal visual acuity (VA) and VA better than 20/200 at 5 years\' follow-up were estimated. Cumulative incidences of complications and additional surgeries by 5 years were calculated. Outcomes were compared between eyes with unilateral PFV and eyes with unilateral non-PFV cataract from our registry.
    RESULTS: Forty-eight of 64 eyes were aphakic postoperatively (median age at surgery 2 months [range 1-13 months]) and 16 were pseudophakic (29 months [range 2-92 months]). Overall, 4 of 42 eyes (10% [95% confidence interval {CI} 3%-23%]) achieved age-normal VA. VA better than 20/200 was achieved in 17 (59% [95% CI 39%-76%]) unilateral aphakic PFV eyes and 44 (43% [95% CI 32%-54%]) unilateral non-PFV aphakic eyes (age-adjusted odds ratio = 1.90 [95% CI 0.81-4.50]; P = .14). The most common complication in aphakic PFV eyes was glaucoma-related adverse events (cumulative incidence 24% [95% CI 9%-37%]). There was no significant difference in glaucoma-related adverse events between PFV and non-PFV eyes in aphakic participants ≤1 year of age at lensectomy (age-adjusted hazard ratio = 1.20 [95% CI 0.54-2.64], P = .66).
    CONCLUSIONS: A wide range of visual outcomes for PFV cataract were observed with a 10% probability of achieving age-normal VA. There was an ongoing risk for the development of glaucoma-related adverse events in PFV eyes.
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  • 文章类型: Journal Article
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  • 文章类型: Case Reports
    牵牛花综合征(MGS)和持续性原发性玻璃体增生(PHPV)是先天性异常,这可能与通过超声诊断的系统性异常和视网膜脱离的发生率增加有关,通过CT识别,MRI,以及眼底检查的确认。
    Morning glory syndrome (MGS) and persistent hyperplastic primary vitreous (PHPV) are congenital abnormity, which may be related to the increased incidence of systemic abnormalities and retinal detachment,diagnosed by ultrasound, identified by CT, MRI, and with the confirmation of fundus examination.
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