Congenital fibrovascular pupillary membranes (CFPM) is defined as a white fibrous membrane across the pupil which may be an ectopic iris tissue arising from the aberrant migration of neural crest cells or a variant of persistent fetal vasculature. The authors report their case series and treatment. This was a retrospective study. All were congenital unilateral cases with no positive family history. Mean age was 6.03 months (3-34 months); 22 male. All were observed from birth. Photophobia was a complaint for 22 cases. Mean follow-up was 15.6 months (10-58 months). The pupil was partially covered in 21 and complete in 12. Six complete cases had glaucoma. Anterior chamber depth was normal in cases of partial membrane but shallow or absent for most of the complete cases. Fundus findings were normal for partial membranes. Half of the complete cases had pale optic discs. Ten of 21 partial membranes were treated with membranectomy and pupilloplasty due to visual axis blockage. Six of 12 complete cases had similar treatment. Six eyes with glaucoma required membranectomy, pupilloplasty, iridectomy and gonio-synechialysis. Histopathology of membrane samples showed composition of mainly fibrous tissue, lymphocytes, pigment epithelial cells and vascular tissues. The limitations of this study are acknowledged as lack of genetic testing, aqueous humour analysis and iris fluorescence angiography and pre to post-surgical outcome measurement comparisons. The authors conclude CFPM has diverse manifestations. Prompt diagnosis and management of associated disease (e.g. glaucoma) and visual axis obscuration are critical.
Management and outcomes of congenital fibrovascular pupillary membranes (CFPM)
Reviewed by Fiona Rowe
Clinical and histopathological features of congenital fibrovascular pupillary membranes in a Chinese case series.
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Fiona Rowe (Prof)
Institute of Population Health, University of Liverpool, UK.
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