[Hyperplastic primary vitreous with persistent hyaloid artery in 2 non-twin brothers]

The authors describe the case of two brothers afflicted with persistent anterior hyperplasic primary vitreous and hyaloid artery. The occurrence of combination in two members of the same family is unusual, also moreover one of the patients was affected by macular retinoschisis. The two cases were clinically different; the first was typical, complicated by cataract; the second presented alterations mostly located in the posterior vitreous. In one eye fluorescein angiography showed a very slow and delayed filling of the hyaloid artery. Blood flow was directed from its anterior portion towards the optic disk. Nd: YAG laser photoresection of the hyaloid artery, performed in order to obtain a better visualization of the macula did not lead to remarkable hemorrhages. In an other eye fluorescein angiography could be performed after Nd: YAG laser photoresection of a vitreous membrane located in front of the posterior pole: remnants of the hyaloid vascular system with retrograde blood filling were present also in this case. The mechanisms leading to this reverse filling of the vessels are discussed.