OCT Angiography of Persistent Hyaloid Artery: A case report

Jeon, Hansol; Kwon, Soonil

doi:10.21203/rs.2.9132/v2

Cited by 1 publication

(3 citation statements)

References 11 publications

(15 reference statements)

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“…In a healthy foetus, regression of the HA itself starts at 18 weeks, and by 29 gestational weeks it disappears leaving clear central zone in the vitreous humour, called Cloquet’s canal [ 3 , 5 , 16 ]. The main trunk of the HA finally closes centrally by the end of gestation [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…PHA is seen in 3% of full term infants and 95% of premature infants [ 4 ]. However, PHA with active blood flow is a rare finding of unknown incidence [ 2 , 3 , 5 ], but when present may be supplying a part of the retinal tissue [ 3 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…PHA is usually associated with mild amblyopia without further complications, although nystagmus, strabismus, cataract, vitreous haemorrhage and retinal detachment have been reported [ 5 , 7 ]. Vitreous haemorrhage in cases of PHA can develop due to tractional force during rapid eye movement phase of sleep, external trauma to the globe, elevated blood pressure, as well as spontaneously [ 5 ]. We herein report for the first time consequential central retinal artery occlusion (CRAO) and central retinal vein occlusion (CRVO) as a complication of PHA in a six-year-old child.…”

Section: Introductionmentioning

confidence: 99%

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Central retinal artery and vein occlusion as a complication of persistent hyaloid artery – a case report

et al. 2020

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Background In this case report, we present for the first time central retinal artery occlusion (CRAO) and central retinal vein occlusion (CRVO) as a complication of persistent hyaloid artery (PHA). Case presentation In August 2019, a six-year-old male patient manifested right eye (RE) excessive tearing, conjunctival injection and pain. On examination, RE demonstrated light perception and intraocular pressure of 36 mmHg. The diagnoses of neovascular glaucoma, CRVO and CRAO were established as affirmed with fluorescein angiography (FA). PHA was not reported. Extensive work-up and family history were unremarkable. The child was born on term after uncomplicated twin pregnancy. In December 2019, he was referred to our Centre. Transillumination revealed fully dilated, non-reactive RE pupil, clear lens and tubular remnant of HA containing blood cells in its lumen freely rotating in the anterior vitreous. Conclusions PHA results from failure of apoptosis during gestation. It can easily be observed during the red reflex screening at neonatal wards. We hypothesized that PHA twisting led to torsion of the residual primordial common bulb, branching off to HA and CRA with CRAO occurring first. The consequential CRVO presumably advanced by venous stasis due to decrease in arterial inflow. Liquid vitreous appears as early as 4 years of age enabling PHA to whirl more freely. Thus, in case of PHA, we advocate FA to be performed and if connection with retinal artery is proven, parents should be informed on the possible devastating complications and prompt surgical treatment should be considered.

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