Subretinal peripapillary neovascularization associated with persistent fetal vasculature

The purpose of this study was to report a unique case of persistent fetal vasculature presenting as peripapillary choroidal neovascularization.

Ophthalmologic examination, examination under anesthesia, fluorescein angiogram, chart review, review of relevant literature. A 2-year 4-month-old white girl was referred for decreased vision and suspicious retinal findings.

Fundus examination of the right eye demonstrated a peripapillary macular scar with old subretinal hemorrhage, subretinal fluid consistent with peripapillary neovascular net, a persistent fetal vascular stalk, and a central posterior lenticular opacity. Fluorescein angiogram of the right eye showed normal arterial filling in the early phase, normal arteriovenous transit, and late staining with mild leakage.

This is a unique case of persistent fetal vasculature presenting with the findings of subretinal exudates and choroidal neovascularization that has not been described before. Although the etiology of the choroidal neovascularization is unclear, we postulate it may be a result of the traction from the persistent fetal vasculature stalk in the peripapillary region. These findings may also be secondary to an optic disk anomaly that was not detected on examination.