Topic outline

  • Grand Rounds

    A patient with a history of sudden vision loss (hand motion) in the left eye following an intravitreal injection for chronic central serous retinopathy (CSR) presented with reduced vision five months later. At the time of presentation, the left eye's visual acuity had improved to 20/150, with an intraocular pressure of 4 mmHg. Medical records indicated that the vision loss was related to post-injection complications, including hyphema and vitreous hemorrhage. Visual acuity in the right eye was limited to 20/1600 due to a history of retinal detachment and anterior ischemic optic neuropathy (AION). On examination, the left eye showed inferior dehemoglobinized vitreous hemorrhage, retinal folds, and an epiretinal membrane (ERM). Optical coherence tomography (OCT) revealed subretinal fluid (SRF) with associated retinal pigment epithelium (RPE) undulation. Ultrasound biomicroscopy (UBM) identified a cyclodialysis cleft in the inferior temporal quadrant, located between the 4 and 6 o’clock positions. The patient subsequently underwent intraoperative argon laser treatment to close the cleft. Postoperative examination confirmed resolution of the subretinal fluid and absence of RPE undulation. Visual acuity in the left eye improved to 20/70, and intraocular pressure stabilized at 13 mmHg.

    Presentation Date: 11/07/2024
    Issue Date:11/08/2024