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Sheeza Basharat
Sheeza Basharat12 days ago
Persistent Pupillary Membrane

Persistent Pupillary Membrane

It represents a common congenital ocular anomaly that appears as fine iris strands along the pupil, which are remnants of anterior tunica vasculosa lentis that supplies nutrition to the lens in the first 6 months of fetal life.⠀ ⠀ ⏩It can be unilateral or bilateral and can be variable in appearance, size, configuration, and density.⠀ ⠀ ⏩Most of the times, it can be seen as thin lacy strands of iris tissue running from the collarette, but a bilateral total persistent membrane is a rare occurrence and is associated with vision deprivation.⠀ ⠀ ⏩The pupillary membrane itself begins to regress in the sixth month and disappears completely by the eighth month of gestation.⠀ ⠀ ⏩There is some more recent evidence that intrauterine stress, particularly from chronic maternal hypertension, may accelerate the disappearance of these membranes.⠀ ⠀ ⏩A failure of cellular activities that result in regression of pupillary membrane leads to its development.⠀ ⠀ ⏩Conversely, a failure in the involution of the posterior hyaloid system leads to the development of a persistent hyperplasic primary vitreous.⠀ ⠀ ⠀ ⏩Most cases with PPMs are not significant enough to have visual complaints and so might go undetected. ⠀ ⠀ ⏩Management of PPMs depends on the extent of the membrane, and consequently the size of the pupillary opening.⠀ ⠀ ✅Small PPMs can be managed conservatively. ⠀ ✅Mydriatics, refractive correction, and patching for amblyopia have been used successfully in some cases.⠀ ⠀ ✅Nd:YAG laser membranectomy has been shown to effectively remove the membrane.⠀ ⠀ ✅It can be excised surgically. But surgical management is fraught with risks of anesthesia, intraoperative bleeding, intraocular infection, and cataract formation.

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