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Yuichiro Ogura - One of the best experts on this subject based on the ideXlab platform.
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Histopathological examination of two cases of anterior staphyloma associated with Peters' Anomaly and persistent hyperplastic primary vitreous
The British journal of ophthalmology, 2001Co-Authors: A Matsubara, Hironori Ozeki, Shoichiro Shirai, Miho Nozaki, Masayuki Ashikari, Noriko Matsunaga, Yuichiro OguraAbstract:AIMS—To clarify the developmental mechanism and critical period for the uncommon complex of Peters' Anomaly and persistent hyperplastic primary vitreous (PHPV). METHODS—Two eyes with Peters' Anomaly and PHPV were histologically examined by serial section. One eye was enucleated at age 7 months (case 1) and the other at age 4 months (case 2) owing to severe anterior staphyloma. RESULTS—In both eyes, defects in the endothelium, Descemet's membrane, and posterior stroma were observed in the central cornea, and the degenerative lens adhered to the posterior surface of the defective corneal stroma. Also, in both eyes, the anterior chamber space was not formed and the undifferentiated iris stroma adhered to the posterior surface of the peripheral cornea. Mesenchymal tissue containing melanocytes was observed behind the degenerative lens, and the pigment epithelium was absent at the lower nasal side of the ciliary body in case 1. In case 2, mesenchymal tissue containing scattered melanocytes in the vitreous cavity was seen on the posterior retina. Based on the histological findings, both cases were diagnosed as Peters' Anomaly caused by the faulty separation of the lens vesicle, PHPV, maldevelopment of the iris and ciliary body, and goniodysgenesis. CONCLUSION—Migratory disorders of neural crest cells from 4 to 7 weeks of gestation may be responsible for various ocular anomalies including Peters' Anomaly and PHPV, as observed in these cases.
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histopathological examination of two cases of anterior staphyloma associated with Peters Anomaly and persistent hyperplastic primary vitreous
British Journal of Ophthalmology, 2001Co-Authors: A Matsubara, Hironori Ozeki, Shoichiro Shirai, Miho Nozaki, Masayuki Ashikari, Noriko Matsunaga, Yuichiro OguraAbstract:AIMS—To clarify the developmental mechanism and critical period for the uncommon complex of Peters' Anomaly and persistent hyperplastic primary vitreous (PHPV). METHODS—Two eyes with Peters' Anomaly and PHPV were histologically examined by serial section. One eye was enucleated at age 7 months (case 1) and the other at age 4 months (case 2) owing to severe anterior staphyloma. RESULTS—In both eyes, defects in the endothelium, Descemet's membrane, and posterior stroma were observed in the central cornea, and the degenerative lens adhered to the posterior surface of the defective corneal stroma. Also, in both eyes, the anterior chamber space was not formed and the undifferentiated iris stroma adhered to the posterior surface of the peripheral cornea. Mesenchymal tissue containing melanocytes was observed behind the degenerative lens, and the pigment epithelium was absent at the lower nasal side of the ciliary body in case 1. In case 2, mesenchymal tissue containing scattered melanocytes in the vitreous cavity was seen on the posterior retina. Based on the histological findings, both cases were diagnosed as Peters' Anomaly caused by the faulty separation of the lens vesicle, PHPV, maldevelopment of the iris and ciliary body, and goniodysgenesis. CONCLUSION—Migratory disorders of neural crest cells from 4 to 7 weeks of gestation may be responsible for various ocular anomalies including Peters' Anomaly and PHPV, as observed in these cases.
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Ocular and systemic features of Peters' Anomaly.
Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2000Co-Authors: Hironori Ozeki, Shoichiro Shirai, Miho Nozaki, Eiji Sakurai, Shin-ichi Mizuno, Masayuki Ashikari, Noriko Matsunaga, Yuichiro OguraAbstract:Background: To clarify the relationship between associated systemic anomalies and ocular manifestations in patients with Peters’ Anomaly, a retrospective study was conducted. Methods: We classified 37 patients with Peters’ Anomaly into two groups, one with (+) and one without (–) systemic anomalies. Results: The systemic Anomaly (+) group consisted of 13 patients, eight males and five females, with mean age of 2.3 months. Peters’ Anomaly was bilateral in six cases and unilateral in seven. Corneolenticular adhesion was observed in 11 cases. Associated ocular anomalies were seen in 12 cases, and developmental glaucoma was present in eight cases. The systemic Anomaly (–) group comprised 24 patients, 13 males and 11 females, with mean age of 28.3 months. Peters’ Anomaly was bilateral in 11 cases and unilateral in 13. Corneolenticular adhesion was observed in five cases. The associated ocular anomalies were observed in 10 cases, and developmental glaucoma was accompanied in six cases. The incidences of cases with corneolenticular adhesion, those with other ocular anomalies, and those with glaucoma were significantly higher in the systemic Anomaly (+) group than in the systemic Anomaly (–) group. Conclusions: Peters’ Anomaly accompanying corneolenticular adhesion and/or other ocular anomalies should be evaluated for the presence of systemic anomalies.
Won Ryang Wee - One of the best experts on this subject based on the ideXlab platform.
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Long-term visual outcomes of penetrating keratoplasty for Peters Anomaly
Graefe's Archive for Clinical and Experimental Ophthalmology, 2013Co-Authors: J W Chang, Mee Kum Kim, Jeong Hun Kim, Seong-joon Kim, Won Ryang WeeAbstract:Background To investigate the long-term results and visual outcomes of penetrating keratoplasty (PKP) in Peters Anomaly. Methods Twenty-three eyes from 22 patients with Peters Anomaly who underwent PKP from 1998 to 2008 were reviewed retrospectively. Patients who were followed for more than 3 years after the first PKP were included in this study. The systemic and ophthalmic features of the recipients were assessed, and the various prognostic factors for graft survival were evaluated. Disease severity was determined according to other accompanying eye anomalies in mild or severe form. The final visual outcomes were presented with respect to graft clarity. Results Among the 22 patients, 14 patients had unilateral disease, and eight patients had bilateral disease. Associated systemic anomalies were observed in six patients. The mean age at the first PKP was 42.4 months. Nineteen eyes (83 %) underwent PKP after 12 months of age. The graft failure rates at 1 year, 3 years, 5 years, and 10 years after PKP were 30 %, 39 %, 70 %, and 77 % respectively. Graft rejection within 1 month after PKP and severe disease were significant risk factors for graft failure. The mean final VAs in the clear-graft group and the failed-graft group were 1.883 logMAR and 2.767 logMAR ( P
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Clinical outcome of penetrating keratoplasty in patients 5 years or younger: Peters Anomaly versus sclerocornea.
Cornea, 2013Co-Authors: Yong Woo Kim, Mee Kum Kim, Hyuk Jin Choi, Won Ryang WeeAbstract:Purpose: To investigate and compare the clinical outcome of primary penetrating keratoplasty in pediatric patients with Peters Anomaly and sclerocornea. Methods: Medical records of 20 eyes of 18 patients with Peters Anomaly or sclerocornea who underwent primary penetrating keratoplasty when they were 5 years or younger were reviewed. The survival rates and median survival times of corneal grafts were evaluated to determine the surgical outcome. Demographics of patients, the preoperative characteristics of recipient eyes, surgical procedures, causes of graft failure, and postoperative complications were analyzed to identify the factors affecting graft survival. Results: A total of 20 penetrating keratoplasties were performed in 18 patients. Eight patients had Peters Anomaly, and 10 patients had sclerocornea. Overall, 50% of corneal grafts survived during the follow-up of 92.7 6 10 months. The graft survival was 65% at 6 months and remained 50% at 12 months, 2 years, and 5 years after surgery. The mean survival time and survival rate were significantly different between patients with Peters Anomaly and those with sclerocornea (the survival time, 135.6 6 17.9 vs. 36.4 6 16.1 months, P = 0.014; the survival rate, 87.5% vs. 25.0%, P = 0.02). The presence of opacity or vascularization in the limbus and in the peripheral cornea and the diameter of the recipient cornea were significantly correlated with graft failure. Conclusions: Penetrating keratoplasty in patients who were 5 years or younger had an excellent surgical outcome in patients with Peters Anomaly, whereas the graft survival was poor in patients with sclerocornea.
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Long-term visual outcomes of penetrating keratoplasty for Peters Anomaly
Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2012Co-Authors: J W Chang, Mee Kum Kim, Jeong Hun Kim, Seong-joon Kim, Won Ryang WeeAbstract:Background To investigate the long-term results and visual outcomes of penetrating keratoplasty (PKP) in Peters Anomaly.
Gerald W Zaidman - One of the best experts on this subject based on the ideXlab platform.
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Peters Anomaly: A 5-year experience.
Paediatric anaesthesia, 2020Co-Authors: Irim Salik, Gerald W Zaidman, Abhishek Gupta, Arjun Tara, Samuel BarstAbstract:BACKGROUND Peters Anomaly is a rare, congenital eye malformation characterized by an opaque cornea and blurred vision. Central corneal opacification can lead to delayed progression of visual development caused by defects in Descemet membrane and the posterior stroma. These children require several anesthetics for multiple eye examinations under anesthesia and corneal transplantation. AIMS We sought to review the anesthetic management of patients with Peters Anomaly for ophthalmologic procedures at Westchester Medical Center, a major referral center for Peters Anomaly. METHODS A retrospective chart review was completed which included pediatric patients who underwent ophthalmologic procedures related to Peters Anomaly from 2013-2018. RESULTS The charts of 35 patients with Peters Anomaly were reviewed: 14 patients with Peters Anomaly Type I, 10 patients with Peters Anomaly Type II, and 11 patients with Peters plus syndrome. Thirty patients required three procedures on average, two examinations under anesthesia pre- and post-transplant, and anesthesia for the corneal transplant itself. The youngest patient encountered for examination under anesthesia was 39-week postconceptual age. Anesthetic time for examination under anesthesia averaged 31 minutes using a laryngeal mask airway while corneal transplant averaged 104 minutes utilizing endotracheal intubation. Postanesthesia care unit stay averaged 51 minutes following examination under anesthesia and 65 minutes after corneal transplant. All examinations under anesthesia were successfully completed without adverse events with the use of a laryngeal mask airway. This case series includes two patients with Goldenhar syndrome and Al-Gazali syndrome accompanying Peters Anomaly. CONCLUSION Although limited by its retrospective nature, this case series describes the cardiac and systemic implications of patients undergoing anesthesia with Peters Anomaly. Our experience indicates that general anesthesia and airway manipulation are tolerated with minor postoperative concerns in these infants. Pediatric patients with Peters Anomaly require multiple anesthetics for repeated ophthalmologic interventions. The laryngeal mask airway can be routinely utilized in infants less than 3 months of age for an eye examination under anesthesia with no airway complications noted. Perioperative providers should be aware of the multisystemic implications in patients with Peters plus syndrome.
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incidence of Peters Anomaly and congenital corneal opacities interfering with vision in the united states
Cornea, 2014Co-Authors: Jeffrey M Kurilec, Gerald W ZaidmanAbstract:Purpose:The aim of this study was to determine the incidence of Peters Anomaly (PA) and congenital corneal opacities (CCO) interfering with vision in the United States.Methods:We collected data from the Eye Bank Association of America (EBAA), the Eye-Bank for Sight Restoration (Eye-Bank) in New York
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long term visual prognosis in children after corneal transplant surgery for Peters Anomaly type i
American Journal of Ophthalmology, 2007Co-Authors: Gerald W Zaidman, Jessica K Flanagan, Catherine C FureyAbstract:Purpose To evaluate the long-term visual prognosis in children with corneal transplant surgery for Peters Anomaly type I. Design Retrospective review of interventional case series. Methods Twenty-four children treated in a university-based practice were divided into two groups for analysis: a younger preverbal group and an older group of children three years of age or older. Children underwent corneal transplantation surgery (penetrating keratoplasty [PKP]) for Peters Anomaly type I as infants (age range, two to 18 months). Visual acuity using Snellen or Allen charts and glaucoma and other complications were tabulated. Results Twenty-four patients had Peters Anomaly; 16 had unilateral disease, eight had bilateral disease. Thirty eyes underwent PKP. Average age at PKP was five months. The mean follow-up from PKP to the most recent visit was 78.9 months. Fifteen eyes (50%) were treated for glaucoma. Five transplants (17%) had graft rejection episodes; two of these failed and were regrafted. Six eyes (20%) required cataract surgery. One eye had a retinal detachment. Currently, 27 eyes (90%) have clear grafts. In the younger group of children, five of six grafts are clear (83%). In the older group of 24 eyes of verbal children, seven eyes (29%) have visual acuity ranging from 20/20 to 20/50, six (25%) have visual acuity ranging from 20/60 to 20/100, nine (38%) have visual acuity ranging from 20/200 to counting fingers, and two eyes (8%) have visual acuity of hand movements. In this group, nine of 12 eyes without glaucoma had visual acuity better than 20/100; only four of 11 eyes with glaucoma were better than 20/100. Conclusions Many children with PKP for Peters Anomaly type I can experience good or functional vision in their operated eye. Children with glaucoma have a poorer visual prognosis.
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Peters Anomaly associated with protruding corneal pseudo staphyloma
Cornea, 1998Co-Authors: Gerald W Zaidman, Kenneth JuechterAbstract:PURPOSE: To describe a new manifestation of Peters' Anomaly. METHODS: We managed four infants with an unusual form of Peters' Anomaly. One eye of each patient had a thickened and scarred cornea, mimicking a corneal staphyloma, protruding anteriorly from the corneal plane. The other eye of each patient ranged from normal to having severe ocular anomalies. A corneal transplant was performed in each case. RESULTS: Follow-up ranged from 1 to 3 years. Three eyes maintained graft clarity for at least 1 year. Each of these eyes developed vision. Two of these eyes developed glaucoma. The one eye with graft failure developed an inoperable retinal detachment. The histopathology of each corneal button showed changes consistent with Peters' Anomaly. CONCLUSIONS: These corneas demonstrated characteristics of both Peters' Anomaly and congenital anterior staphyloma. Despite their severe anomalies, surgery successfully restored a more normal cosmetic appearance in all four eyes and vision in three eyes.
Irene H Maumenee - One of the best experts on this subject based on the ideXlab platform.
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Visual outcome after surgery for Peters' Anomaly
Ophthalmic genetics, 1994Co-Authors: Subba R. Gollamudi, Elias I Traboulsi, Wallace Chamon, Walter J. Stark, Irene H MaumeneeAbstract:The authors reviewed the charts of 22 patients with Peters' Anomaly. Various surgical procedures were performed on 30 eyes of 18 patients (mean number of procedures = 3.3 per eye). Follow-up averaged six years. Visual acuity varied widely, with six eyes having an acuity of 20/400 or better, and 11 eyes with no light perception. Concomitant or secondary glaucoma required a greater number of surgical procedures (4.1 vs 3.4) per eye and was associated with a poorer visual outcome. No eyes with glaucoma had visual acuity better than 20/400. In bilaterally operated patients, visual results in one eye were independent of the outcome of the fellow eye. The range of visual acuity in bilaterally operated patients was similar to the vision in those operated unilaterally.Visual outcome in patients with Peters' Anomaly remains guarded. With modern surgical techniques and aggressive attempts at visual rehabilitation, many patients may benefit from surgery. Some patients may have moderately good visual acuity for month...
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Peters Anomaly and associated congenital malformations
Archives of Ophthalmology, 1992Co-Authors: Elias I Traboulsi, Irene H MaumeneeAbstract:• We reviewed the clinical findings in 29 patients with Peters' Anomaly. There was developmental delay in 15 patients, congenital heart disease in eight patients, external ear abnormalities in five patients, structural defects of the central nervous system in four patients, genitourinary malformations in four patients, cleft lip/palate in three patients, hearing loss in three patients, spinal defects in two patients, and single cases of other less common defects. One patient had fetal alcohol syndrome; one, Pfeiffer's syndrome; and one, short stature, ulnar hypoplasia, and joint laxity. Colobomatous microphthalmia was present in seven patients, and persistent hyperplastic primary vitreous in three patients. Ten patients developed glaucoma, and three had retinal detachment unrelated to ocular surgery. Peters' Anomaly may be due to a developmental field defect, or the complex ocular and systemic malformations may be the result of a contiguous gene syndrome or of a defective homeotic gene controlling the development of the eye and other body structures.
A Matsubara - One of the best experts on this subject based on the ideXlab platform.
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histopathological examination of two cases of anterior staphyloma associated with Peters Anomaly and persistent hyperplastic primary vitreous
British Journal of Ophthalmology, 2001Co-Authors: A Matsubara, Hironori Ozeki, Shoichiro Shirai, Miho Nozaki, Masayuki Ashikari, Noriko Matsunaga, Yuichiro OguraAbstract:AIMS—To clarify the developmental mechanism and critical period for the uncommon complex of Peters' Anomaly and persistent hyperplastic primary vitreous (PHPV). METHODS—Two eyes with Peters' Anomaly and PHPV were histologically examined by serial section. One eye was enucleated at age 7 months (case 1) and the other at age 4 months (case 2) owing to severe anterior staphyloma. RESULTS—In both eyes, defects in the endothelium, Descemet's membrane, and posterior stroma were observed in the central cornea, and the degenerative lens adhered to the posterior surface of the defective corneal stroma. Also, in both eyes, the anterior chamber space was not formed and the undifferentiated iris stroma adhered to the posterior surface of the peripheral cornea. Mesenchymal tissue containing melanocytes was observed behind the degenerative lens, and the pigment epithelium was absent at the lower nasal side of the ciliary body in case 1. In case 2, mesenchymal tissue containing scattered melanocytes in the vitreous cavity was seen on the posterior retina. Based on the histological findings, both cases were diagnosed as Peters' Anomaly caused by the faulty separation of the lens vesicle, PHPV, maldevelopment of the iris and ciliary body, and goniodysgenesis. CONCLUSION—Migratory disorders of neural crest cells from 4 to 7 weeks of gestation may be responsible for various ocular anomalies including Peters' Anomaly and PHPV, as observed in these cases.
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Histopathological examination of two cases of anterior staphyloma associated with Peters' Anomaly and persistent hyperplastic primary vitreous
The British journal of ophthalmology, 2001Co-Authors: A Matsubara, Hironori Ozeki, Shoichiro Shirai, Miho Nozaki, Masayuki Ashikari, Noriko Matsunaga, Yuichiro OguraAbstract:AIMS—To clarify the developmental mechanism and critical period for the uncommon complex of Peters' Anomaly and persistent hyperplastic primary vitreous (PHPV). METHODS—Two eyes with Peters' Anomaly and PHPV were histologically examined by serial section. One eye was enucleated at age 7 months (case 1) and the other at age 4 months (case 2) owing to severe anterior staphyloma. RESULTS—In both eyes, defects in the endothelium, Descemet's membrane, and posterior stroma were observed in the central cornea, and the degenerative lens adhered to the posterior surface of the defective corneal stroma. Also, in both eyes, the anterior chamber space was not formed and the undifferentiated iris stroma adhered to the posterior surface of the peripheral cornea. Mesenchymal tissue containing melanocytes was observed behind the degenerative lens, and the pigment epithelium was absent at the lower nasal side of the ciliary body in case 1. In case 2, mesenchymal tissue containing scattered melanocytes in the vitreous cavity was seen on the posterior retina. Based on the histological findings, both cases were diagnosed as Peters' Anomaly caused by the faulty separation of the lens vesicle, PHPV, maldevelopment of the iris and ciliary body, and goniodysgenesis. CONCLUSION—Migratory disorders of neural crest cells from 4 to 7 weeks of gestation may be responsible for various ocular anomalies including Peters' Anomaly and PHPV, as observed in these cases.