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Case Report: Persistent fetal vasculature associated with lenticular coloboma
Naiyu Sun1, Jinchang Tian1, Hong Zhang1
1Ophthalmology department, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
Background:
Persistent fetal vasculature (PFV) is a rare congenital ocular anomaly, featuring typical fibrovascular stalks in the vitreous cavity. PFV may cause anterior and posterior segment anomalies such as leukocoria, microphthalmos, cataract, elongated ciliary processes, optic nerve hypoplasia, intralenticular hemorrhage, retinal dysplasia and strabismus. However, cases of PFV concurrent with lenticular coloboma are rarely reported. This report presents a rare case of anterior PFV associated with lenticular coloboma.
Case Presentation:
A 23-year-old female presented with poor vision since childhood and deteriorated visual acuity in the right eye for 10 years. Dilated examination showed a localized central posterior subcapsular opacity in the lens, a fibrous stalk on the central posterior capsule extending to the vitreous cavity, elongated ciliary processes on the nasal area. Also a crescent-shaped lens defect and zonular defect was observed at the nasal equatorial region. Anterior segment optical coherence tomography (AS-OCT) examination provided a clear visualization of a band-shaped high reflectivity signal on the central posterior capsule, extending into the vitreous cavity. Lens coloboma along with zonular defect was also visualized by 3D reconstructed images of AS-OCT scan. The patient received an optimized surgery of cataract and anterior vitrectomy, during which a capsular tension ring implantation was made and an IOL was implanted into capsular bag in one surgery. Ethical approval for this observational retrospective study was waived by the Ethics Committee of our hospital and a written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Conclusion:
This case represents a rare coexistence of PFV and lens coloboma. The report highlights the distinctive diagnostic value of AS-OCT in identifying anterior PFV and discusses the application of optimized surgical strategies in the management of this complex presentation.
