Persistent hyperplastic primary vitreous: magnetic resonance imaging and clinical findings

This study presents magnetic resonance imaging (MRI) findings of both the anterior and posterior types of persistent hyperplastic primary vitreous (PHPV) to facilitate the differential diagnosis from other intraocular abnormalities.

Seventeen patients with PHPV who were evaluated using non-contrast and contrast-enhanced T1- and T2-weighted images were retrospectively reviewed.

Among the 17 patients with PHPV (6 males, 11 females), 13 had unilateral PHPV (11 left eyes, 2 right eyes), and 4 had bilateral PHPV. The MRI findings of the anterior type of PHPV included a shallow or collapsed anterior chamber, an anterior segment anomaly, and a retrolental vascular membrane which demonstrated hyperintensity after contrast enhancement. The MRI findings of the posterior type consisted of microphthalmos; a tubular image, representing the hyaloid vessel; a funnel-shaped retinal detachment, with the subretinal fluid hyperintense on both T1- and T2-weighted images; the fluid-fluid level, which was hypointense on both T1- and T2-weighted images and probably corresponded to the presence of hemorrhage in the subretinal space; a retrolental mass; and vitreous hemorrhage. The most common clinical presentations of patients with PHPV in our study were microphthalmos, a shallow or collapsed anterior chamber, and leukocoria.

The presentation of PHPV at different stages was variable; the MRI features of PHPV along with clinical findings were able to facilitate the differential diagnosis from other intraocular abnormalities such as retinoblastoma and Coats' disease.