Persistent Hyperplastic Primary Vitreous.pptx

This PPT is about a case of Persistent Hyperplastic Primary Vitreous

1. Case Presentation A rare case of a 8years old girl child with Persistent Hyperplastic Primary Vitreous (PHPV) PRESENTED BY:-Dr. Ranjita Amanatya 1st year PG, VIMSAR, Burla

2. Name:- Lagna Rana Age:- 8years Sex:- Hindu Female Child Address:- Atabira,Bargarh,Odisha Chief complaint :- Diminution of vision & white spot in R.E. since birth HOPI :- To start with a 8years old female child presented with her father to the EYE OPD with complain of diminution of vision & white spot in her R.E. since birth which was painless, not associated with watering,redness,discharg , floaters.

3. HISTORY OF PAST ILLNESS:- FAMILY HISTORY:- PERSONAL HISTORY:- Not a k/c/o Thyroid disease, Sickle cell disease No h/o ocular trauma/ head injury No h/o any ocular surgery/ laser treatment No h/o allergies No h/o antenatal/ perinatal complications & the mother’s serology was negative No known ocular disease Patient had normal body built Normal developmental milestone Normal bowel & bladder habit Patient was on mixed Indian diet

4. GENERAL EXAMIATION:- Pt. is conscious, oriented to time, place & person No pallor, icterus, clubbing, K oilonychia , lymphadenopathy , e dema B .P.:- 100/72 mmHg P .R.:- 92 beats/min SYSTEMIC EXAMINATION:- Chest:- B/L symmetrical VBS heard CVS :-S1 S2 no murmur CNS :- NAD

5. OCULAR EXAMINATION:- Visual Acuity IOP AR EOM PL(+ ve ),PR(inaccurate) 6/6 14mmHg 12mmHg OD OS No S +0.00 Target C -0.25 A 10° B/L & full in all directions
(BES)

6. OD OS Eyelid Microphthalmos Normal Eyelashes Normal Normal Conjunctiva Quite Quite Cornea Clear Clear AC (Content & Depth) Normal Normal Iris Normal Normal Pupil Cir/LR(+ ve ) (Sluggish) Leukocoria Cir/LR(+ ve ) Lens Cataractous Clear Anterior Segment Examination:-

7. SLIT LAMP EXAMINATION :- Leukocoria Cataractous lens

8. Posterior Segment Examination:- OD OS Mydriasis Mid-dilated Good Ocular media Hazy Normal Optic disc Size Normal Shape Couldn’t Normal Colour be Pink Margin assessed Well defined C:D Ratio 0.3:1

9. OD OS Macula Couldn’t FR(+ nt ) Blood vessels A:V be 2:3 Periphery assessed Normal General Fundus WNL Posterior Segment Examination cont. :-

10. A wide echogenic band extending from the back of the lens to the front of the optic disc in the right vitreous cavity USG B-SCAN (OD):-

11. USG B-SCAN (OD):-

12. INVESTIGATIONS :- Blood & Urine :- WNL Viral markers :- Non-reactive USG B-SCAN Persistent hyaloid remnants MRI Orbit Triangular retro- lental tissue { MARTINI GLASS appearance } Persistent hyaloid remnants

13. Treatment plan :- Surgery:- (Due to abnormal lens morphology & Advanced stage of PHPV) Vitrectomy with lensectomy & capsulotomy under
general anaesthesia was planned to remove the fibrovascular tissue & cataractous lens Unfortunately she was rejected for general anaesthesia owing to cardiomegaly

14. Mixed PHPV with cataractous lens in the right eye PROVISIONAL DIAGNOSIS:-