Surgical management and histologic and immunohistochemical features of a cataract and retrolental plaque secondary to persistent hyperplastic tunica vasculosa lentis/persistent hyperplastic primary vitreous (PHTVL/PHPV) in a Bloodhound puppy

Abstract

The objective of this study was to describe the clinical, histologic and immunohistochemical features, the surgical treatment, and outcome of a cataract secondary to persistent hyperplastic tunica vasculosa lentis/persistent hyperplastic primary vitreous (PHTVL/PHPV) in a dog. A 4-month-old male Bloodhound dog presented for evaluation of a cataract. A complete ophthalmic examination and ocular ultrasonography were performed. A resorbing cataract with intralenticular hemorrhage, lens induced uveitis, and PHTVL/PHPV were diagnosed. Extracapsular cataract extraction using phacoemulsification was performed. A primary posterior capsulectomy was performed to remove a retrolental plaque with the posterior capsule; the excised plaque was submitted for histopathology and immunohistochemical staining. A 41-Diopter intraocular lens (IOL) was implanted. Functional vision was maintained postoperatively during the 21-month follow-up period. Histologically, the posterior capsule was coiled and exhibited duplication. The retrolental plaque was comprised of dense fibrous connective tissue, blood vessels, free red blood cells, hemosiderin-laden macrophages, a pocket of neural tissue and numerous perivascular mast cells. With immunohistochemical staining, the neural elements were determined to be glial cells compatible with astrocytes. Cataract secondary to PHTVL/PHPV can be successfully treated using phacoemulsification and planned posterior capsulectomy. Posterior lens capsule duplication, mast cells and astrocytic glial cells may be normal components of the fibrovascular retrolental plaque associated with PHTVL/PHPV.

Canine cataracts, diabetes mellitus and spontaneous lens capsule rupture: a retrospective study of 18 dogs

“…The eyes with spontaneous capsule rupture in this study demonstrated severe phacoclastic uveitis, fibroplasia and secondary glaucoma if prompt referral and early surgical intervention was not performed. This is expected based on the large size of the spontaneous capsular rupture, typically 90–180°, and correlates with what is seen with traumatic canine lens capsular tears 4,5 …”

“…Spontaneous lens capsule rupture has been reported in the rabbit, 11–14,45,46 mouse, 7,15 rat 16 and human 4,17–21,47 . The location of the capsular rupture varies, with it being located anterior axial in canine traumatic rupture, 9 posterior in the RLC mouse 7,15 and Sprague–Dawley rat, 16 anterior in rabbits, 11 anterior in humans with Alport's disease, 4,6,48 and posterior in association with persistent hyperplastic primary vitreous/persistent tunica vasculosa lentis in dogs, 5 mice 22 and humans 8 . In rabbits, spontaneous lens capsule rupture is seen most commonly in the dwarf rabbit and is thought to be associated with Encephalitozoon cuniculi 13,14,46 .…”

“…Lens capsule rupture may occur spontaneously as a result of penetrating trauma, in relation to specific developmental disorders, 4–8 or as an inadvertent complication of cataract surgery. While trauma is most frequently the cause of lens capsule rupture, 9,10 spontaneous lens capsule rupture has been reported in the rabbit, 11–14 mice, 7,15 rats 16 and humans 4,6,17–21 .…”

Update on veterinary cataract surgery

“…This is imperative due to the advanced stages of cataracts often seen in our patients precluding evaluation of the posterior segment. B-scan ultrasound using a 10 mHz probe is used to evaluate for vitreal degeneration/asteroid hyalosis, retinal detachment, posterior lenticonus, PHPV/PHTVL, axial length of the lens and globe and presence of spontaneous lens capsule rupture [8, [13][14][15]. It has been shown in the canine eye that the prevalence of vitreal degeneration and retinal detachment increases with progression of cataract [15].…”

Unilateral persistent hyperplastic tunica vasculosa lentis and persistent hyperplastic primary vitreous in a rabbit

“…It has been described in many species including dogs, cats, horses, rats, mice, llamas, ferrets, rabbits, and recently in pinnipeds . Many canine breeds are affected.…”