Abstract A new syndrome of ocular maldevelopments in infants born prematurely has been reported previously.1 No conclusive statement can be made at this time as to the exact cause or causes of this entity. However, a discussion of the various etiologic factors, stressing the theory that now appears most logical, is of value in bringing the problem to the attention of many observers. By this means the solution may be arrived at more quickly, with regard not only to the most satisfactory preventive measures but to the best treatment, perhaps soon enough to be of practical value for infants now under observation. This syndrome, consisting primarily in bilateral fibroplasia, is based on : (1) persistence of some part of the tunica vasculosa lentis system, (2) growth of embryonic connective tissue behind the crystalline lens and/or (3) persistence of the fibrillar structure of the vitreous humor. It has been pointed out1c References 1. Terry, T. L.: (a) Am. J. Ophth. 25:203, 1942 2. Hess, J. H.; Mohr, G. J., and Bartelme, P. F.: The Physical and Mental Growth of Prematurely Born Children , Chicago, University of Chicago Press, 1934. 3. Hac, L. R. ; Adair, F. L., and Hesseltine, H. C. : Am. J. Obst. & Gynec. 38:57, 1939. 4. Ross, S. G., and Mallory, H. T.: Canad. M. A. J. 45:417, 1941. 5. Goldberg, H.: Personal communication to the author. Goldberg has observed 5 infants with fibroplasia, concerning whom he wrote after seeing my preliminary report of the condition.1a 6. Clifford, S.: Personal communication to the author. 7. Needham, J.: Chemical Embryology , London, Cambridge University Press, 1931, vol. 3. 8. Blackfan, K. D., and Yaglou, C. P.: Premature Infant , Am. J. Dis. Child. 46:1175 ( (Nov.) , pt. 2) 1933. 9. McCrady, E.: Embryology of the Opossum , Philadelphia, Wistar Institute of Anatomy and Biology, 1938. 10. To evaluate some of the factors which might be involved, experiments are being carried out with (1) variations in temperature, (2) variations in light, (3) vitamin deficiency, (4) decrease in the oxygen-carrying powers of the blood by exposure to carbon monoxide and by feeding of sulfanilamide, (5) intraocular injection of blood, (6) graded constriction of the neck and (7) injection of pressor and depressor substances to vary the blood pressure. As a therapeutic measure of possible value, the sulfuric acid ester of hyaluronic acid was injected into eyes of opossum pouch young in which the hyaloid arterial system was still present, to determine whether this would stimulate a precocious closure of the arterial system. This ester was supplied by Dr. Karl Meyer, of the Eye Institute, New York. Animals were chosen for the experiments whose young had a patent hyaloid arterial system at birth. The opossum has been used in many experiments, because, since it is a marsupial, the young are born in a very immature stage. Pregnant and newborn rats, cats and pigs have also been used. To date none of the experiments has gone far enough to enable me to report scientifically significant results. However, several trends of interest, one of possible therapeutic value, have been noted. 11. Held, R.: Arch. f. Anat. u. Entwcklungsgesch. , 1896, p. 222. 12. Salzmann, M.: Anatomy and Development of the Human Eyeball , translated by E. V. L. Brown, Chicago, University of Chicago Press, 1912, p. 208. 13. J. Exper. Med. 76:1, 1942 14. Bessey, O., and Wolbach, B.: J. Exper. Med. 69:1, 1939. 15. From the Blood Grouping Laboratory of the Children's Hospital. 16. Woodbury, R. A.; Robinson, M., and Hamilton, W. F.: Am. J. Physiol. 122:472, 1938. 17. Hess,2 figures 66 and 67, p. 284. 18. Patten, B. M.: Anat. Rec. 35:129, 1931. 19. Christie, A.: Normal Closing Time of Foramen Ovale and Ductus Arteriosus , Am. J. Dis. Child. 40:323 ( (Aug.) ) 1930. 20. Eppinger, E. C.; Burwell, C. S., and Gross, R. E.: J. Clin. Investigation 20:127, 1941. 21. Wislocki, G. B.: Personal communication to the author. 22. Graybiel, A.; Allen, A. W., and White, P. D.: J. Clin. Investigation 14:52, 1935. 23. Reid, M. R.: Abnormal Arteriovenous Communications , Arch. Surg. 11:25 ( (July) ) 1925. 24. Haden, H. C. : Personal communication to the author.
Archives of Ophthalmology – American Medical Association
Published: Jan 1, 1943