Persistent hyperplastic primary vitreous with myopia: a case study.
BACKGROUND
Persistent hyperplastic primary vitreous (PHPV) is a congenital disorder that manifests a range of ocular anomalies, including leukocoria, microphthalmia, cataract, and a retrolental fibrovascular membrane. In general, the prognosis for visual acuity with PHPV has been poor. A recent report on six patients who have myopia associated with PHPV showed that these patients were not microphthalmic, did not manifest leukocoria, and showed a mean visual acuity at final followup of 20/160.


METHODS
The case of a 3-year-old boy with myopic PHPV of the left eye is presented. Full-time wear of the cycloplegic refraction, combined with patching of the non-amblyopic eye, resulted in an improvement in visual acuity.


RESULTS
PHPV with myopia may constitute a distinct subtype of PHPV. Patients with myopic PHPV tend to seek treatment later than patients with anterior or posterior PHPV as a result of the lack of microphthalmia and leukocoria. These individuals do not show the long-term complications, such as secondary glaucoma and intraocular hemorrhages, associated with PHPV.


CONCLUSIONS
The acuity improvement in this case of myopic PHPV suggests that a more conservative approach to its surgical management may be appropriate while pursuing refractive correction and amblyopia therapy to attain the best acuity possible.
Steele
G
G
Illinois College of Optometry, Chicago, USA.
Peters
R
R
D002675:Child, Preschool; D003937:Diagnosis, Differential; D005124:Eye Abnormalities / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D005130:Eye Hemorrhage / Q000209:etiology; D005500:Follow-Up Studies; D005901:Glaucoma / Q000209:etiology; D006801:Humans; D008297:Male; D008850:Microphthalmos / Q000150:complications; D009216:Myopia / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D012029:Refraction, Ocular; D012683:Sensory Deprivation; D014792:Visual Acuity; D014822:Vitreous Body / Q000002:abnormalities*