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Persistent hyperplastic primary vitreous

Case contributed by Dr Anand Shrikant Gajakos
Diagnosis almost certain

Presentation

Leukocoria, right monocular blindness.

Patient Data

Age: 4 years
Gender: Male

The right eye globe is small in size.

An elongated thick echogenic band is seen in the posterior segment extending from the lens up to the optic nerve head. This echogenic band shows a small sized artery showing continuous biphasic blood flow on doppler, in keeping with persistent hyaloid artery.

Ciliary process is thick and echogenic. Lens is small, echogenic with irregular contour.

Case Discussion

Embryologically the primary vitreous forms around 7th week of gestational life and starts regressing at around 20-21 weeks of gestational life and is completely regressed at the time of birth.

Pathologically it is a condition in which the embryonic hyaloid artery fail to regress. Persistence of this leads to fibrosis resulting in cataract, retinal detachment, and ciliary process hypertrophy.

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