Assessment of spontaneous movements in an infant with Peters anomaly

Objective: Peters anomaly is a rare form of segment dysgenesis of the anterior chamber of the eye, which may lead to bilateral glaucoma, corneal opacity and cataract. In addition, it may also be associated with other ocular and systemic abnormalities.

Case report: The patient was born without prenatal complications at 41 gestational weeks, with an APGAR score of 9/10/10. Bilateral corneal opacity was diagnosed shortly after birth. An ophthalmological investigation during anaesthesia revealed a severe mesodermal developmental disorder/Peters anomaly. As it is known that infants with retinopathy have abnormal spontaneous movements, we recorded the spontaneous activity of our patient at the infant's age of 6 and 14 weeks. General movements were assessed offline with a special focus on fidgety movements (FMs), the age-adequate general movement pattern.

Results: At 6 weeks, the movements were jerky, stiff, and monotonous. "Fidgety-like movements" of slow speed lacked fluency and occurred predominantly on the trunk. Roving eye movements were obvious. At 14 weeks, again, movements were stiff and monotonous. "Fidgety-like movements" now also occurred on the extremities. However, they were too slow and without the typical fluent and elegant character compared to normal FMs. In addition, the body posture was not symmetrical and the head was not in midline. Frequently, head anteflexions were observed; monotonous tongue and mouth movements occurred; and, again roving eye movements were seen. Hardly, movements towards the midline occurred.

Conclusion: The impairment of the visual system in Peters anomaly is associated with abnormal "fidgety-like movements" and a less optimal motor repertoire.