Phacoemulsification for Cataract Secondary to Persistent Hyperplastic Tunica Vasculosa Lentis and Peristent Hyperplastic Primary Vitreous in a Welsh Corgi

A 7-month-old Cardigan Welsh Corgi was presented with rapid cataract formation. Slit lamp biomicroscopy revealed mature cataract in the left eye. Ultrasonography revealed a microphakic lens and the presence of a cord-like structure extending from the posterior lens to the optic disc. On the basis of ophthalmological examinations, a diagnosis of cataract secondary to persistent hyperplastic tunica vasculosa lentis and persistent hyperplastic primary vitreous was made. Routine phacoemulsifi cation with a capsular tension ring and intraocular lens implantation were performed. Although a blood-fi lled vasculature with focal hemorrhage was observed during surgery, we did not fenestrate the posterior capsule or cut the hyaloid artery. We only polished the posterior capsule carefully for 2 min. At 22 days after surgery, Doppler ultrasonography did not detect blood fl ow within the cord-like structure, and the implanted intraocular lens appeared clear without fi brin formation or posterior capsule opacifi cation. The fi ndings from this case suggest that routine cataract surgery is an optimal surgical treatment for persistent hyperplastic tunica vasculosa lentis and persistent hyperplastic primary vitreous. To the best of our knowledge, this is the fi rst case report of phacoemulsifi cation with intraocular lens implantation for persistent hyperplastic tunica vasculosa lentis and persistent hyperplastic primary vitreous in a Welsh Corgi.

Anterior–Posterior Persistent Fetal Vasculature With Multiple Stalks: Persistent Vasa Hyaloidea Propria

An 8-week-old boy referred for an abnormal pupil was found to have an atypical presentation of persistent fetal vasculature (PFV) with multiple vascular stalks. Examination under anesthesia with fluorescein angiography (FA) revealed 2 perfused persistent hyaloid vessels, one extending from the optic disc and another from the inferonasal retina. These vessels meet anteriorly to form a vascular network at the lens, which is the remnant of the tunica vasculosa lentis. Although the posterior portion of PFV typically presents as a single stalk attached at the optic disc, this case features an atypical presentation of 2 distinct vascular stalks, which may expand our understanding of ocular development and pathogenesis of PFV. We hypothesize that the aberrant additional stalk may represent failure of the vasa hyaloidea propria (tributaries of the hyaloid artery) to regress.

Usefulness of Intravitreal Bevacizumab for Retinopathy of Prematurity with Severely Dilated Tunica Vasculosa Lentis and Poor Mydriasis

Background: Laser therapy has been the gold standard treatment for retinopathy of prematurity (ROP), while intravitreal bevacizumab (IVB) is reported to be of significant benefit for zone I ROP. A problem with laser therapy is that it is difficult to administer in ROP patients with severely dilated tunica vasculosa lentis and poor mydriasis. However, although IVB treatment has been performed in such severe ROP cases, only 1 report has discussed its usefulness. Case 1: A male infant was born with a birth weight of 382 g at 23 weeks’ gestation. As visualization was poor and laser therapy could not be performed due to dilated tunica vasculosa lentis and poor mydriasis, IVB (0.625 mg/0.025 mL) was administered to both eyes. Following treatment, the ROP gradually improved, with regression of the dilated tunica vasculosa lentis and improvement of the mydriasis in both eyes. Case 2: A male infant was born with a birth weight of 698 g at 25 weeks’ gestation. As laser therapy could not be performed due to severely dilated tunica vasculosa lentis and poor mydriasis, IVB (0.625 mg/0.025 mL) was administered to both eyes. Following treatment, the ROP gradually improved, with regression of the dilated tunica vasculosa lentis and improvement of the mydriasis in both eyes. Conclusions: IVB is potentially more useful than laser therapy for the treatment of severe ROP with dilated tunica vasculosa lentis and poor mydriasis.