Prepapillary Vascular Loop Associated with Persistent Hyperplastic Primary Vitreous

A 66-year-old woman was referred for evaluation of retinal vessel abnormality. She had no visual symptoms. The anterior segment showed a retrolental opacity in her right eye. Fundus examination showed a bilateral prepapillary vascular loop associated with PHPV in her right eye. Prepapillary vascular loops were present in both eyes, although they were much more prominent in the right eye. To our knowledge, there are no reports of prepapillary vascular loops associated with PHPV. 1. Introduction Prepapillary vascular loop formations are uncommon congenital vascular malformations and the majority is of arterial origin [1]. They are usually detected incidentally on routine fundus examination but have been associated with retinal vascular occlusive disease and recurrent vitreous bleeding [2]. Prepapillary vascular loops are quite rare, with the incidence ranging from approximately one in 2000 to one in 9000 patients. Bilaterality occurs in 9–17% of these cases [3]. Persistent hyperplastic primary vitreous (PHPV) is a rare congenital developmental malformation of the eye and is caused by the failure of regression of the primary vitreous characterized by microphthalmia, a shallow anterior chamber, elongated ciliary processes, a posterior subcapsular cataract, and a fibrovascular stalk that extends from the optic disc to the lens to varying degrees [4]. PHPV can occur with other ocular and/or systemic disorders. To our knowledge, there are no reports of prepapillary vascular loops associated with PHPV. Herein, we describe the case of such a patient. 2. Case Report A 66-year-old woman was referred for evaluation of retinal vessel abnormality. She had no visual symptoms. She had a history of hypertension, hyperlipidemia, and cerebral un-ruptured aneurysm. Her visual acuity was 1.0 bilaterally. The anterior segment showed a retrolental opacity in her right eye. Fundus examination showed a bilateral prepapillary vascular loop associated with PHPV in her right eye. Prepapillary vascular loops were present in both eyes, although they were much more prominent in the right eye (Figures 1(a), 1(b), and 1(c)). Figure 1: Fundus photographs showing a bilateral prepapillary vascular loop (a, b) and persistent hyperplastic primary vitreous in the right eye (c). 3. Discussion Embryologically, the developing part of the front section of the eye receives its nutrients from a hyaloid artery, which is an intraocular vascular system between the retina and crystalline lens [4]. During later stages of development, this hyaloid system completely regresses, and its role is gradually