A Case Report of Persistent Fetal Vasculature with Posterior Staphyloma and its Management

Dr. Roopa R. Naik, Dr. Nidhi O. Singh

Abstract: Persistent fetal vasculature (PFV) is an ocular developmental disorder resulting from incomplete apoptosis of the embryonic hyaloid vasculature. Unilateral PFV is traditionally associated with a poor prognosis because of the challenges associated with its management. We report a child with unilateral PFV with posterior staphyloma who underwent lens aspiration, primary posterior capsulotomy, anterior vitrectomy, excision of the anterior portion of the stalk of PFV, with cauterization of the hyaloid stalk, and intraocular lens (IOL) implantation. The final best corrected visual acuity was 6/9 (P) in the affected eye and without evidence of glaucomatous optic neuropathy. This case illustrates the excellent visual outcome possible in a child with complex, unilateral PFV using an intensive management approach comprising early surgical intervention, glaucoma monitoring, meticulous monitoring of refraction, visual acuity and intraocular pressure, and motivated parents who engaged in the management.

Keywords: Persistent fetal vasculature, posterior staphyloma, lens aspiration, primary posterior capsulotomy, anterior vitrectomy, cauterization of hyaloid stalk, intraocular pressure, myopia, refraction