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Hata T, Koyanagi A, Yamanishi T, Bouno S, Takayoshi R, Miyake T. Natural Course of Fetal Hyaloid Artery: SlowflowHD Longitudinal Study. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:2259-2267. [PMID: 34859899 DOI: 10.1002/jum.15911] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/29/2021] [Accepted: 11/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To assess the natural course of the fetal hyaloid artery (FHA) using SlowflowHD during pregnancy. METHODS One-hundred and eighteen normal fetuses were studied longitudinally using SlowflowHD to assess the natural course of FHA at 18-21 + 6, 28-31 + 6, and after 35 weeks of gestation. Blood flow of FHA with/without its branches (BF) was evaluated using SlowflowHD, and the band of FHA without blood flow (Band) was identified in each gestational period. The natural course of FHA was classified into six types: Type A, not detected (ND) in each gestational period; Type B, Band at 18-21 + 6 weeks; Type C, Band at 18-21 + 6 and 28-31 + 6 weeks; Type D, BF at 18-21 + 6 weeks; Type E, BF at 18-21 + 6 weeks and Band at 28-31 + 6 weeks; Type F, BF at 18-21 + 6 and 28-31 + 6 weeks. RESULTS BF, Band, and ND were 83.5, 15.5, and 1.0% at 18-21 + 6 weeks, 8.8, 15.5, and 75.7% at 28-31 + 6 weeks, and 0, 0, and 100% after 35 weeks, respectively. Type A was 1.0%, Type B was 13.6%, Type C was 1.9%, Type D was 61.2%, Type E was 13.6%, and Type F was 8.7%. CONCLUSIONS The presence of FHA blood flow before 30 weeks of gestation should be regarded as a physiologic phenomenon in normal fetuses.
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Affiliation(s)
- Toshiyuki Hata
- Department of Obstetrics and Gynecology, Miyake Clinic, Minami-ku, Okayama, Japan
- Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, Miki, Kagawa, Japan
| | - Aya Koyanagi
- Department of Obstetrics and Gynecology, Miyake Clinic, Minami-ku, Okayama, Japan
| | - Tomomi Yamanishi
- Department of Obstetrics and Gynecology, Miyake Clinic, Minami-ku, Okayama, Japan
| | - Saori Bouno
- Department of Obstetrics and Gynecology, Miyake Clinic, Minami-ku, Okayama, Japan
| | - Riko Takayoshi
- Department of Obstetrics and Gynecology, Miyake Clinic, Minami-ku, Okayama, Japan
- Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, Miki, Kagawa, Japan
| | - Takahito Miyake
- Department of Obstetrics and Gynecology, Miyake Clinic, Minami-ku, Okayama, Japan
- Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, Miki, Kagawa, Japan
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Bjeloš M, Križanović A, Bušić M, Kuzmanović Elabjer B. Central retinal artery and vein occlusion as a complication of persistent hyaloid artery - a case report. BMC Ophthalmol 2020; 20:434. [PMID: 33143669 PMCID: PMC7607849 DOI: 10.1186/s12886-020-01702-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/23/2020] [Indexed: 11/21/2022] Open
Abstract
Background In this case report, we present for the first time central retinal artery occlusion (CRAO) and central retinal vein occlusion (CRVO) as a complication of persistent hyaloid artery (PHA). Case presentation In August 2019, a six-year-old male patient manifested right eye (RE) excessive tearing, conjunctival injection and pain. On examination, RE demonstrated light perception and intraocular pressure of 36 mmHg. The diagnoses of neovascular glaucoma, CRVO and CRAO were established as affirmed with fluorescein angiography (FA). PHA was not reported. Extensive work-up and family history were unremarkable. The child was born on term after uncomplicated twin pregnancy. In December 2019, he was referred to our Centre. Transillumination revealed fully dilated, non-reactive RE pupil, clear lens and tubular remnant of HA containing blood cells in its lumen freely rotating in the anterior vitreous. Conclusions PHA results from failure of apoptosis during gestation. It can easily be observed during the red reflex screening at neonatal wards. We hypothesized that PHA twisting led to torsion of the residual primordial common bulb, branching off to HA and CRA with CRAO occurring first. The consequential CRVO presumably advanced by venous stasis due to decrease in arterial inflow. Liquid vitreous appears as early as 4 years of age enabling PHA to whirl more freely. Thus, in case of PHA, we advocate FA to be performed and if connection with retinal artery is proven, parents should be informed on the possible devastating complications and prompt surgical treatment should be considered. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-020-01702-8.
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Affiliation(s)
- Mirjana Bjeloš
- Department of Ophthalmology, Reference Centre for Paediatric Ophthalmology and Strabismus of the Ministry of Health of the Republic of Croatia, Sveti Duh University Hospital, Sveti Duh 64, Zagreb, Croatia.,Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.,Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Ana Križanović
- Department of Ophthalmology, Reference Centre for Paediatric Ophthalmology and Strabismus of the Ministry of Health of the Republic of Croatia, Sveti Duh University Hospital, Sveti Duh 64, Zagreb, Croatia.,Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Mladen Bušić
- Department of Ophthalmology, Reference Centre for Paediatric Ophthalmology and Strabismus of the Ministry of Health of the Republic of Croatia, Sveti Duh University Hospital, Sveti Duh 64, Zagreb, Croatia. .,Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia. .,Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.
| | - Biljana Kuzmanović Elabjer
- Department of Ophthalmology, Reference Centre for Paediatric Ophthalmology and Strabismus of the Ministry of Health of the Republic of Croatia, Sveti Duh University Hospital, Sveti Duh 64, Zagreb, Croatia.,Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.,Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
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Bronshtein M, Gabbay-Benziv R, Gover A, Gilboa Y, Bardin R. Prenatal Sonographic Abnormal Appearances of the Fetal Hyaloid Artery: From Normal Variants to Pathology. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:1935-1941. [PMID: 28480545 DOI: 10.1002/jum.14226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 12/13/2016] [Indexed: 06/07/2023]
Abstract
This is a case series on the abnormal sonographic appearance and outcome of the fetal hyaloid artery (HA) detected during between 1987 and 2015 at one medical center. Fifteen cases were detected during fetal anatomy scans, usually performed at 14 to 16 weeks' gestation. Three other cases were diagnosed following referral for a second opinion. In nine fetuses, the HA regressed normally throughout pregnancy. Of them, eight neonates had normal outcomes and one had cataract at the same eye. All nine other cases ended with adverse outcomes. Failure of the HA to regress in the third trimester appears to be an indicator of congenital blindness.
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Affiliation(s)
- Moshe Bronshtein
- Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel, and Faculty of Social Welfare and Health Sciences Haifa University, Israel
| | - Rinat Gabbay-Benziv
- Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ayala Gover
- Neonatal Intensive Care Unit, Lady Davis Carmel Medical Center, and Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Yinon Gilboa
- Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat-Gan, Israel, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ron Bardin
- Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Sarnat HB, Resch L, Flores-Sarnat L, Yu W. Precocious synapses in 13.5-week fetal holoprosencephalic cortex and cyclopean retina. Brain Dev 2014; 36:463-71. [PMID: 24529974 DOI: 10.1016/j.braindev.2014.01.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 01/10/2014] [Accepted: 01/11/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Genetic programming of cerebral development involves tissue morphogenesis and also timing of developmental processes. Precocious synaptogenesis in the neocortical plate was previously demonstrated in 5 of 6 fetuses of 20-31 weeks gestation. MATERIALS AND METHODS Neuropathological examination was performed of a 13-week-5-day fetus with trisomy-13, a lobar holoprosencephaly, hydrocephalus, cyclopia and absence of ears. Immunocytochemical demonstration of the synaptic vesicle protein synaptophysin was performed in the brain and retina, along with other neuronal markers. RESULTS Synaptophysin reactivity in the cortical plate was patchy and precocious. Radial glial fibres, demonstrated by vimentin, were oriented parallel to the cortical plate rather than perpendicular, probably because of hydrocephalus. A corpus striatum was not identified, but the poorly formed thalamus exhibited synaptophysin reactivity around many neurones. The cyclopean eye had ocular features of maturational delay including persistent hyaloid artery; ganglion cells were reduced in number, but retinal synaptophysin reactivity was paradoxically precocious. CONCLUSIONS Holoprosencephaly exhibits abnormal patchy synapse distribution in the neocortex and retina; synaptogenesis was precocious, as we previously described in older fetuses. Too soon an onset of synapse formation may promote early epileptic circuitry, leading to severe infantile epilepsies postnatally. The visual system is the last of the special sensory systems to mature, yet in this case showed too early synapse formation. In HPE, cyclopia and in trisomy 13, total absence of external ears has not been reported; it results from faulty craniofacial induction by neural crest.
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Affiliation(s)
- Harvey B Sarnat
- Department of Paediatrics, University of Calgary Faculty of Medicine and Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada; Department of Pathology (Neuropathology), University of Calgary Faculty of Medicine and Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada; Department of Clinical Neurosciences, University of Calgary Faculty of Medicine and Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.
| | - Lothar Resch
- Department of Pathology (Neuropathology), University of Calgary Faculty of Medicine and Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Laura Flores-Sarnat
- Department of Paediatrics, University of Calgary Faculty of Medicine and Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada; Department of Clinical Neurosciences, University of Calgary Faculty of Medicine and Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Weiming Yu
- Department of Pathology (Paediatric), University of Calgary Faculty of Medicine and Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
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