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Sharel C. Ongchin, Avery Weiss; Posterior Polymorphous Dystrophy: A Proposed Mechanism for Associated High Myopia. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5984.
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To propose a novel theory for posterior polymorphous dystrophy (PPMD) and associated high myopia
Retrospective chart analysis of 5 patients with PPMD and high myopia. Data recorded included age, visual acuity, refraction, axial length, and corneal curvatures.
We report 5 cases of patients with PPMD and high refractive myopia. All patient had high myopia, ranging from -6.0 diopters to -17.0 diopters. Axial lengths ranged from 19.3mm to 23.5mm, and keratometry measurements ranged from 50.0 D to 60.0 diopters.
PPMD is spectrum of clinical and morphological findings. We are reporting a subset of patients with PPMD and associated high refractive myopia. We propose that the corneal curvature in these patients does not flatten from its infantile corneal curvature due to the abnormal extracellular and collagen matrix within the cornea. In patients with PPMD, the abnormal deposition of abundant collagen fibrils can potentially affix the cornea in its state of neonatal curvature during which the typical cornea has 60 diopters of refractive power. The high myopia would be persistent of the high corneal curvature. This abnormal extracellular and collagen matrix may also have implications regarding elevated IOP which has previously been documented in these patients.
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