Cooccurrence of myelinated retinal nerve fibers in pediatric unilateral persistent fetal vasculature: report of three cases.

We report 3 pediatric cases of persistent fetal vasculature (PFV) and myelinated retinal nerve fibers (MRNF) coexisting in the same eye. All cases presented with congenital cataracts, vitreous strands, and an unusual axial length (AL) profile-specifically, the affected eyes exhibited longer ALs than their fellow eyes, contrary to typical PFV patterns. Preoperative Color Doppler imaging consistently revealed a linear echogenic band extending from the optic disk to the posterior lens capsule. Intraoperative and postoperative fundus examinations confirmed the presence of MRNF in each case, with variable distribution and density. Our findings suggest that when axial elongation is detected preoperatively in PFV eyes with the fundus obscured by cataract, coexisting conditions such as MRNF should be considered.