A 3-month-old infant has leukocoria of the right eye. The right globe is microphthalmic, the anterior chamber is shallow, and a retrolental vascularised fibrous mass is seen with stretched ciliary processes drawn centrally. B-scan ultrasonography shows no calcification. The MOST likely diagnosis is:

• A Retinoblastoma
• B Persistent fetal vasculature ✓
• C Coats disease
• D Toxocara endophthalmitis

Explanation

Persistent fetal vasculature (formerly persistent hyperplastic primary vitreous) is a unilateral condition of term infants combining microphthalmos, shallow anterior chamber, retrolental fibrovascular plaque, and elongated ciliary processes pulled toward the lens. Absence of calcification on ultrasound effectively excludes retinoblastoma, which is calcified in about 90 percent of cases. Coats disease occurs in older boys and shows massive exudation rather than a retrolental plaque with microphthalmos.

Reference: Taylor and Hoyt's Pediatric Ophthalmology and Strabismus, 5th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.