Persistent fetal vasculature detected by prenatal ultrasound

Abstract

Ultrasound is usually performed during pregnancy in order to assess fetal anatomy. We report a case of a newborn patient with unilateral congenital cataract diagnosed by prenatal ultrasound at 22 weeks’ gestation. Postnatal ophthalmic B-scan ultrasound and doppler echography disclosed a small, spherical lens, with cataractous changes, and a tubular stalk of fibrovascular tissue attached to the posterior surface of the opacified lens, connecting to the optic nerve, consistent with persistent fetal vasculature (PFV) in the right eye. Left eye was otherwise normal. After born, the patient was submitted to surgery by the 12th week of life. Twenty-five-gauge sutureless lensectomy technique was performed through the pars plicata approach. The lens nucleus and cortex were aspirated in the bag. Anterior vitrectomy and removal of the PFV stalk was performed. At follow up, by 26 months of age, the best corrected visual acuity was 20/100 in the affected eye. Prenatal ultrasound with accurate evaluation and analysis of the eyes can provide early ophthalmic diagnosis and early referral, providing a prompt surgical approach soon after birth in order to avoid amblyopia and childhood blindness.