Best-corrected visual acuity improved to 20/40 OS. One month later the patient reported spontaneous improvement in vision. C, Four months after the initial visit, there is complete release of posterior hyaloid attachment to the retina with residual intraretinal edema nasal to the fovea. Central foveal thickness is decreased and measures 180 µm. B, One month later the posterior hyaloid is more elevated and located 1020 µm anterior to the retina but the area of vitreoretinal attachment is decreased. There are cystic intraretinal spaces produced by vitreous traction in the fovea. Treatment was observation at this time with pars plana vitrectomy to be considered to relieve the traction if visual loss persisted in the setting of quiescent uveitis.Ī, On the patient's initial visit, the optical coherence tomographic image demonstrates a partially detached posterior hyaloid located 750 µm anterior to the retina, which is characteristic of vitreomacular traction. The OCT image of the left eye revealed a partially detached posterior hyaloid exerting traction on the fovea and secondary intraretinal thickening with large cystic spaces ( Figure 1, A). Fluoroscein angiography did not reveal cystoid macular edema. Dilated fundus examination revealed a normal retina in the right eye and multiple foveal cysts in the left eye. Slitlamp examination revealed trace pigmented cells in the anterior chambers of both eyes. Applanation tonometry revealed intraocular pressures of 19 mm Hg in the right eye and 27 mm Hg in the left, likely secondary to the corticosteroid injection. The patient was referred to our retina service for evaluation of continuing decreased vision in her left eye.īest-corrected Snellen visual acuity was 20/30 OD and 20/70 OS. Six weeks before referral to us, visual acuity dropped further to 20/80 OS and a sub-Tenon triamcinolone acetonide injection was administered in the left eye. Five months before her initial visit to us, her visual acuity dropped to 20/60 OS from 20/25 OS. The patient is a 60-year-old white woman with a 1½-year history of stable, bilateral intermediate uveitis treated with prednisolone acetate drops twice daily in both eyes. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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