Abstract
Purpose :
Current management strategies for congenital corneal opacity (CCO) patients are not satisfactory because of high complication rates after corneal transplantation. There have been cases that show spontaneous regression among CCO patients. We herein evaluated the incidence of spontaneous regression in CCO patients and analyzed associated factors.
Methods :
This study consisted of CCO patients who visited Seoul National University Children’s Hospital and Seoul National University Bundang Hospital between 1 September 2009 and 30 June 2018 with a follow-up duration of at least 8 months. We reviewed medical records for demographical, ocular and systemic characteristics, such as age, sex, diagnosis, laterality, TORCH, follow-up duration, opacity location, opacity grading, iris abnormality, intraocular pressure, cataract, cornea size, and limbal vascularization. The anterior segment photographs were reviewed to determine the extent and density of opacity.
Results :
Among 55 eyes of 39 patients, 24 eyes of 16 patients showed spontaneous regression. Among those with spontaneous regression, 25.0% of the patients were male and 75.0% were female, while of those without spontaneous regression, 65.2% of the patients were male and 34.8% were female (p=0.013). A greater portion of patients with Peters’ anomaly had spontaneous regression compared to those without Peters’ anomaly (p=0.027). Limbal vascularization had significant correlation with spontaneous regression (p=0.046). However, other factors including laterality, TORCH, opacity location, opacity grading, iris abnormalities, increased intraocular pressure, presence of cataract, or cornea size had no association with spontaneous regression. The mean age of the regression was 7.9 months patients with Peters’ anomaly and 6.5 months in those without limbal vascularization.
Conclusions :
About 40% of CCO patients showed spontaneous regression at the mean age of less than 8 months. We suggest that it might be a viable option to carefully observe the change of the opacities until the age of 8 months in selected cases with no limbal vascularization and with the diagnosis of Peters' anomaly. Further prospective studies with larger study populations are needed to validate our findings.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.