A newborn is found to have bilateral leukocoria. Ocular ultrasound shows no calcification, and the lenses are clear. The anterior chambers are shallow with iridocorneal adhesions. The most likely diagnosis is:

• A Bilateral retinoblastoma
• B Congenital cataract
• C Persistent fetal vasculature (PFV) ✓
• D Primary congenital glaucoma with corneal edema

Explanation

PFV typically presents with unilateral leukocoria, microphthalmia, shallow anterior chamber, and retrolenal fibrovascular tissue without calcification. Bilateral PFV is rare but possible. Bilateral retinoblastoma would show calcification on CT/ultrasound. Congenital cataract shows an opaque lens, not a clear lens with iridocorneal adhesions. Congenital glaucoma causes corneal edema with large globes, not shallow anterior chambers with iridocorneal adhesions.

Reference: Pediatric Ophthalmology and Strabismus, AAO BCSC, 2023-2024 ed.

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Written and medically reviewed by the StethoPrep medical team.