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Unmasking a Silent Persistent Hyaloid Artery: A Rare Cause of Vitreous Hemorrhage in an Elderly Patient

Year: 2025

Type: article

Abstract: Persistent hyaloid artery (PHA) rupture is a rare cause of vitreous hemorrhage, particularly in older adults, as hyaloid remnants typically regress during early life. We report the case of a 70-year-old man who presented with sudden, painless vision loss in the left eye due to dense vitreous hemorrhage. Immediate pars plana vitrectomy was performed, during which an actively bleeding PHA was identified and successfully cauterized. Intraoperative video documentation provided direct visualization of the ruptured embryonic vessel, confirming the diagnosis. No retinal tears, retinal detachment, or neovascularization were noted. Postoperatively, the patient experienced progressive visual recovery, ultimately returning to his baseline visual acuity. This case expands the known age spectrum of symptomatic PHA, demonstrates the diagnostic and therapeutic value of early vitrectomy in non-clearing hemorrhage, and underscores the importance of considering congenital vascular remnants in the differential diagnosis of spontaneous vitreous hemorrhage in elderly patients.

Source: Cureus

DOI: 10.7759/cureus.98980

Authors: Eirini Maliagkani, Aikaterini Chatzara, Konstantina Chronopoulou, Ioannis Tservakis

Institutions: National and Kapodistrian University of Athens, General Hospital of Athens G. Genimatas

Language: English

Topic: Retinal and Macular Surgery

Subfield: Radiology, Nuclear Medicine and Imaging

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4417248360