Peters Anomaly Differential Diagnoses

Updated: Sep 12, 2018
  • Author: Danielle Trief, MD; Chief Editor: Donny W Suh, MD, FAAP  more...
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DDx

Diagnostic Considerations

Posterior keratoconus: The posterior keratoconus has minimal opacity. Histopathologically, in Peters anomaly, the corneal endothelium and the Descemet membrane are thin or absent. In posterior keratoconus, the Descemet membrane and the endothelium are present, and the Descemet membrane demonstrates abnormal anterior banding, multilaminar configuration, and/or posterior excrescences. [28] No iris adhesions are seen in posterior keratoconus.

Sclerocornea: Sclerocornea and Peters anomaly both result from anterior segment dysgenesis and share common findings, including anterior synechiae, posterior embryotoxon, and prominent iris processes. However, Peters anomaly presents with a clear cornea in the periphery, whereas sclerocornea has scleral tissue extension and vascularization in the periphery of the cornea. [18] In sclerocornea, the entire cornea is opacified and flattened.

Trauma: This includes birth trauma from forceps delivery, which can result in tears in the Descemet membrane and subsequent corneal clouding.

Other differential diagnoses to be considered are as follows:

  • Intrauterine keratitis
  • Mucopolysaccharidoses and other metabolic disorders
  • Congenital hereditary endothelial dystrophy
  • Corneal dermoids
  • Congenital glaucoma

Differential Diagnoses