An Intraoperative Discovery of a Unilateral Pulsating Heartbeat—An Atypical Case of Persistent Foetal Vasculature in the Vitreous with a Silent B-Scan

Author:

Sipra Shivani1,Ramesh Prasanna Venkatesh2,Devadas Aji Kunnath3,Ray Prajnya3,Ramesh Shruthy Vaishali4,Rajasekaran Ramesh4,Ramesh Meena Kumari4

Affiliation:

1. Department of Paediatric Ophthalmology and Strabismus, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India

2. Department of Glaucoma and Research, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India

3. Department of Optometry and Visual Science, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India

4. Department of Cataract and Refractive Surgery, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India

Abstract

The foetal vasculature gives nourishment to the developing lens and retina during embryonic development and then regresses after the formation of the retinal vessels. The failure of the foetal ocular vasculature to go through the usually planned involution results in persistent foetal vasculature (PFV), which causes blindness or severe vision loss. In this case, we are reporting a 6-week-old baby with unilateral PFV, which was not evident on ultrasound and was diagnosed incidentally during surgery. The dense, vascularized membrane typically seen behind the lens in these patients may seriously compromise cataract surgery, causing intraoperative bleeding that is sometimes severe enough to force the surgeon to abandon the surgery. The creation of new treatment approaches has been made possible by the recent improvements in micro-invasive surgical methods, which made the early treatment of PFV safer and more successful.

Publisher

Medknow

Reference5 articles.

1. Persistent fetal vasculature;Chen;Asia Pac J Ophthalmol (Phila),2019

2. Bilateral persistent hyperplastic primary vitreous: A case report and review of the literature;Maqsood;Cureus,2021

3. Congenital cataract associated with persistent fetal vasculature: Findings from IoLunder2;Solebo;Eye (Lond),2016

4. Results of cataract surgery and plasma ablation posterior capsulotomy in the anterior persistent hyperplastic primary vitreous;Sinha;Middle East Afr J Ophthalmol,2013

5. Unilateral persistent hyperplastic primary vitreous: Intensive management approach with an excellent outcome beyond visual maturation;Yusuf;BMJ Case Rep,2015

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