Posters

Where did that blood come from? Atypical presentation of congenital cataract with hemorrhage

Poster Details

First Author: B.Bostanci Ceran TURKEY

Co Author(s): H. Arifoglu   E. Tasindi                 

Abstract Details

Purpose:

Persistent fetal vasculature (PFV), is a congenital developmental ocular anomaly due to the incomplete regression of the embryonic hyaloid vascular system by the time of birth. Here we present a unique case of congenital cataract with PFV, where the remnants of the vascular system were clinically and radiologically undetected.

Setting:

Okan University, School of Medicine

Methods:

A 6-month-old boy presented with visually significant cataract in the left eye. Examination revealed dens posterior lens opacity with hemorrhage. B scan ultrasonography was normal, showing anechoic posterior segment. Lensectomy and biopsy of the lenticular material was planned under anesthesia. During careful hydrodisection, the coagulated hemorrhage was washed out of the anterior chamber, revealing the dense posterior plaque lying on the posterior lens capsule. The plaque was peeled off in a circular movement preserving the posterior capsule intact. Posterior capsulorrhexis and anterior vitrectomy was performed.

Results:

Histopathological examination of the posterior capsular plaque revealed degenerated cystic spaces with fibrin formation secondary to bleeding and reactive lens epithelial hyperplasia.CD 31 dye of the specimen showed vascular structures which may be the remnants of fetal vasculature.

Conclusions:

Cataract surgery in patients with PFV presents different degrees of difficulty, and initial surgical plan may change depending on the pre and intraoperative conditions. Despite careful USG, the stalk may not be visible in some cases.  The surgeon must be aware of the situation and be prepared with endocoagulation instruments and techniques to deal with the situation.

Financial Disclosure:

None