Looking upon genesis of persistent fetal vasculature on account of clinical observation

Abstract

Objective To understand fetal development in normal eyes and to illustrate involved controversies through a series of observations in 2 typical persistent fetal vasculature (PFV). Methods From February 2011 to January 2012 at Peking University Third Hospital, image data prior to surgery and series of photographs during the procedures were carefully collected and reviewed comparatively with surgical video record. Novel tissue samples obtained from surgeries were observed histopathologically. With literature review, comprehensive analysis was carried out to explore current controversies and illustrate the process of embryonic development. Results Majority of the abnormal signs were concomitant with those that Goldberg described. Pigment epithelium layer of iris detoured over stroma through pupil to adhere with the back surface of cornea, which manifested as an iris cyst. Trace of fetal development supplied a hard evidence that corneal endothelium was originated from neuroectodermal cells. Network profile of persistent pupillary membrane tended to be formed by anterior tunica vasculosa lentis while the remnants were coated by iris stromal tissues which were believed to be originated from neural crest cells. Conclusions Closed relation between corneal endothelium and pigment epithelium of iris at early stage of fetal development is evidenced by clinical observations. Corneal endothelium and descemet' s membrane are most possibly originated from neuroectodermal and spread with the manner migrated from center to periphery. Neural crest cells go forward to center from periphery via the staggered gap between developing endothelium and anterior surface of optic cup to form stroma of iris. Mechanism of persistent pupillary membrane formation could be a result of mutualism between anterior tunica vasculosa lentis and neural crest cells. Key words: Persistent fetal vasculature; Corneal endothelium; Persistent papillary Membrane; Fetal development