Persistent fetal vasculature is a congenital condition in which the embryonic blood vessels that nourish the developing lens and vitreous fail to regress completely. It can lead to structural abnormalities in the lens, vitreous, and retina.
Features
Typical findings include a stalk of tissue behind the lens, a small or cataractous lens, and, in more severe cases, retinal folds or detachment. The condition is often unilateral and may be associated with microphthalmia.
- Usually identified in infancy because of a white pupil or poor visual behaviour
- Anterior, posterior, or combined forms are recognised
- Intraocular pressure problems and glaucoma can occur
- Nystagmus and strabismus may develop in affected eyes
Management
Treatment depends on the severity and includes surgical approaches to remove cataractous lens material, clear visual axes, and manage retinal complications where feasible. Visual prognosis is variable and generally better in milder, predominantly anterior cases.
- Early intervention aims to maximise the potential for useful vision
- Ongoing amblyopia therapy and refractive correction are often required
- Regular follow-up monitors for glaucoma and retinal changes
- Parents benefit from counselling about likely outcomes and treatment stages
