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Waleed Alsarhani, Hind Al-Khatan, Azza Maktabi, Deepak P. Edward, Igor Kozak; Clinical and pathologic characterization of persistent fetal vasculature associated with vitreous hemorrhage.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2424.
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© 2017 Association for Research in Vision and Ophthalmology.
To provide clinical and pathological features of persistent posterior fetal vasculature presenting with vitreous hemorrhage.
Clinical and histopathologic analysis of consecutive pediatric case series with persistent fetal vasculature (PFV) who underwent pars plana vitrectomy with tissue excision. Vitreous hemorrhage was indication for surgery in all cases. The hyaloid stalk was carefully separated from the optic nerve using bimanual technique in all cases. The tissue was examined by light microscopy and the tissue components examined using histochemical and immunohistochemical stains.
Case 1 was a 1 year old male with PFV reaching up to the posterior lens capsule. Case 2 and 3 (four and nine-year-old male) had histories of blunt trauma. B-scans in case 2 revealed vitreous hemorrhage and an intravitreal tissue attached to the optic disc. B-scans in case 3 revealed growth of tissue attached to the optic disc and appearance of vitreous hemorrhage 4 months after trauma. Vitreous hemorrhage was indication for surgery in all cases. Pre-operative visual acuity in cases 1, 2 and 3 was undetermined due to age, hand motion and light perception, respectively. During vitrectomy a fibrotic stalk attached to the optic nerve was identified and removed in all cases. Pathologically, the specimens consisted of fibrovascular tissue and enveloping pockets of hemorrhage. The fibrovascular tissue contained smooth muscle actin positive like spindle-shaped myofibroblasts (n=2) with a low KI-67 index (n=3); hemosiderin laden macrophages (n=3) were also observed. Glial fibrillary acidic protein stain was negative in the three specimens. Post-operative visual acuity in cases 1,2 and 3 was undetermined due to age, 20/70 and light perception, respectively. There was no recurrence of the vitreous hemorrhage.
Vitreous hemorrhage can result from bleeding into posterior persistent fetal vasculature following blunt trauma. The hemorrhage within the persistent fetal vasculature may result in organization of the hemorrhage and a reactive process in the hyaloid stalk. The outcomes following vitrectomy appeared to be good.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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