Abordaje clínico visual de un paciente pediátrico con persistencia de la vasculatura fetal y catarata congénita: reporte de caso

Abstract

Persistent fetal vasculature is a rare congenital ocular anomaly resulting from the failure of regression of the hyaloid vascular system during intrauterine development, which may be associated with other conditions such as congenital cataract and can lead to severe visual impairment. The aim of this case report is to describe the clinical manifestations and the visual health approach in a pediatric patient with persistent fetal vasculature associated with congenital cataract. A descriptive case report was conducted in a male patient evaluated from two months of age, with a history of unilateral leukocoria identified during the first days of life. The clinical approach included ophthalmologic and optometric evaluations, ocular ultrasound, surgical management consisting of cataract extraction and anterior vitrectomy, followed by visual rehabilitation with rigid contact lens correction, occlusion therapy, and long-term follow-up. During follow-up, sequelae such as mild microphthalmia, iris heterochromia, megapapilla, ocular deviation, and limited visual recovery were observed despite continuous treatment. In conclusion, persistent fetal vasculature associated with congenital cataract represents a diagnostic and therapeutic challenge, in which early intervention and continuous follow-up are essential for visual prognosis, highlighting the fundamental role of the pediatric optometrist in comprehensive patient management.