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Recurrent macular detachment and retinoschisis associated with intrachoroidal cavitation in a normal eye.

Akimoto M, Akagi T, Okazaki K, Chihara E - Case Rep Ophthalmol (2012)

Bottom Line: These were treated with intravitreal bevacizumab and then absorbed within 9 months.These were absorbed within 4 months without treatment.This case suggests that similar cases of cystoid macular edema after cataract surgery can occur, and that intrachoroidal cavitation is observed not only in eyes with pathologic myopia but also in normal eyes with peripapillary atrophy; intrachoroidal cavitation can cause macular detachment and retinoschisis.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology and National Hospital Organization, and Kyoto University Graduate School of Medicine, Kyoto, and Japan.

ABSTRACT

Purpose: To describe a patient with intrachoroidal cavitation in the normal eye that caused self-limiting recurrent macular detachment and retinoschisis.

Case report: An 80-year-old female patient with intrachoroidal cavitation in the normal eye presented with macular detachment and retinoschisis after cataract surgery. These were treated with intravitreal bevacizumab and then absorbed within 9 months. One year after cataract surgery, the patient presented with macular detachment and retinoschisis in the same eye again. These were absorbed within 4 months without treatment.

Conclusion: This case suggests that similar cases of cystoid macular edema after cataract surgery can occur, and that intrachoroidal cavitation is observed not only in eyes with pathologic myopia but also in normal eyes with peripapillary atrophy; intrachoroidal cavitation can cause macular detachment and retinoschisis.

No MeSH data available.


Related in: MedlinePlus

a Scanning laser ophthalmoscopic image of b and c. b SD-OCT near the disc. Serous detachment (d) and retinoschisis (s) are observed. c Enlarged figure of b. Intrachoroidal cavitations (arrowheads) and cystic space (*) adjacent to the disc are observed. These spaces appear connected. d SD-OCT around the macular area. Serous detachment (d), retinoschisis (s) and intrachoroidal cavitation (arrowhead) are observed. Photoreceptor segments at the foveola are missing. e SD-OCT 2 months after onset. Serous detachment is almost fully absorbed. Retinoschisis (s), intrachoroidal cavitation (arrowhead) and cystic space (*) can still be seen. f SD-OCT 4 months after onset. Photoreceptor segments are almost repaired. Retinoschisis has also diminished. Intrachoroidal cavitation (arrowhead) and cystic space (*) are observed. g Color photograph of the right disc. PPA is observed. No pit is detected. A yellow-orange lesion is observed around PPA. h Color photograph of the left disc. PPA is observed. No pit is detected. i Horizontal section of SD-OCT around the disc in the left eye. Intrachoroidal cavitation (arrowhead) and cystic space (*) are observed. j Vertical section of SD-OCT around the disc in the left eye. Intrachoroidal cavitation (arrowhead) is observed.
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Figure 2: a Scanning laser ophthalmoscopic image of b and c. b SD-OCT near the disc. Serous detachment (d) and retinoschisis (s) are observed. c Enlarged figure of b. Intrachoroidal cavitations (arrowheads) and cystic space (*) adjacent to the disc are observed. These spaces appear connected. d SD-OCT around the macular area. Serous detachment (d), retinoschisis (s) and intrachoroidal cavitation (arrowhead) are observed. Photoreceptor segments at the foveola are missing. e SD-OCT 2 months after onset. Serous detachment is almost fully absorbed. Retinoschisis (s), intrachoroidal cavitation (arrowhead) and cystic space (*) can still be seen. f SD-OCT 4 months after onset. Photoreceptor segments are almost repaired. Retinoschisis has also diminished. Intrachoroidal cavitation (arrowhead) and cystic space (*) are observed. g Color photograph of the right disc. PPA is observed. No pit is detected. A yellow-orange lesion is observed around PPA. h Color photograph of the left disc. PPA is observed. No pit is detected. i Horizontal section of SD-OCT around the disc in the left eye. Intrachoroidal cavitation (arrowhead) and cystic space (*) are observed. j Vertical section of SD-OCT around the disc in the left eye. Intrachoroidal cavitation (arrowhead) is observed.

Mentions: A year after cataract surgery, the patient presented with decreased vision and central scotoma in her right eye to Kyoto Medical Center. Her visual acuity was 20/100 OD and 20/16 OS. RS-3000 spectral-domain OCT examination (SD-OCT; Nidek Co. Ltd., Tokyo, Japan) showed macular detachment and retinoschisis extending to PPA (fig. 2a–c). Photoreceptor segments were missing at the foveola (fig. 2d). Intrachoroidal cavitations connecting to the cystic space were observed adjacent to the disc (fig. 2c). The connection between the intrachoroidal cavitation and cystic space appeared as breakage of Elschnig's collagenous limiting tissue, which connects the choroid to the optic disc. Since the patient refused further examinations, such as fluorescent angiography, SD-OCT was used to monitor the condition monthly. Serous retinal detachment and retinoschisis gradually absorbed, and was almost fully absorbed 4 months after onset (fig. 2e, f). Her visual acuity recovered to 20/20. A yellow-orange lesion was observed in her right eye (fig. 2g) but not in her left eye (fig. 2h). The left eye also showed intrachoroidal cavitation; however, no incidence of retinoschisis or retinal detachment has been noted (fig. 2i, j).


Recurrent macular detachment and retinoschisis associated with intrachoroidal cavitation in a normal eye.

Akimoto M, Akagi T, Okazaki K, Chihara E - Case Rep Ophthalmol (2012)

a Scanning laser ophthalmoscopic image of b and c. b SD-OCT near the disc. Serous detachment (d) and retinoschisis (s) are observed. c Enlarged figure of b. Intrachoroidal cavitations (arrowheads) and cystic space (*) adjacent to the disc are observed. These spaces appear connected. d SD-OCT around the macular area. Serous detachment (d), retinoschisis (s) and intrachoroidal cavitation (arrowhead) are observed. Photoreceptor segments at the foveola are missing. e SD-OCT 2 months after onset. Serous detachment is almost fully absorbed. Retinoschisis (s), intrachoroidal cavitation (arrowhead) and cystic space (*) can still be seen. f SD-OCT 4 months after onset. Photoreceptor segments are almost repaired. Retinoschisis has also diminished. Intrachoroidal cavitation (arrowhead) and cystic space (*) are observed. g Color photograph of the right disc. PPA is observed. No pit is detected. A yellow-orange lesion is observed around PPA. h Color photograph of the left disc. PPA is observed. No pit is detected. i Horizontal section of SD-OCT around the disc in the left eye. Intrachoroidal cavitation (arrowhead) and cystic space (*) are observed. j Vertical section of SD-OCT around the disc in the left eye. Intrachoroidal cavitation (arrowhead) is observed.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
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getmorefigures.php?uid=PMC3369248&req=5

Figure 2: a Scanning laser ophthalmoscopic image of b and c. b SD-OCT near the disc. Serous detachment (d) and retinoschisis (s) are observed. c Enlarged figure of b. Intrachoroidal cavitations (arrowheads) and cystic space (*) adjacent to the disc are observed. These spaces appear connected. d SD-OCT around the macular area. Serous detachment (d), retinoschisis (s) and intrachoroidal cavitation (arrowhead) are observed. Photoreceptor segments at the foveola are missing. e SD-OCT 2 months after onset. Serous detachment is almost fully absorbed. Retinoschisis (s), intrachoroidal cavitation (arrowhead) and cystic space (*) can still be seen. f SD-OCT 4 months after onset. Photoreceptor segments are almost repaired. Retinoschisis has also diminished. Intrachoroidal cavitation (arrowhead) and cystic space (*) are observed. g Color photograph of the right disc. PPA is observed. No pit is detected. A yellow-orange lesion is observed around PPA. h Color photograph of the left disc. PPA is observed. No pit is detected. i Horizontal section of SD-OCT around the disc in the left eye. Intrachoroidal cavitation (arrowhead) and cystic space (*) are observed. j Vertical section of SD-OCT around the disc in the left eye. Intrachoroidal cavitation (arrowhead) is observed.
Mentions: A year after cataract surgery, the patient presented with decreased vision and central scotoma in her right eye to Kyoto Medical Center. Her visual acuity was 20/100 OD and 20/16 OS. RS-3000 spectral-domain OCT examination (SD-OCT; Nidek Co. Ltd., Tokyo, Japan) showed macular detachment and retinoschisis extending to PPA (fig. 2a–c). Photoreceptor segments were missing at the foveola (fig. 2d). Intrachoroidal cavitations connecting to the cystic space were observed adjacent to the disc (fig. 2c). The connection between the intrachoroidal cavitation and cystic space appeared as breakage of Elschnig's collagenous limiting tissue, which connects the choroid to the optic disc. Since the patient refused further examinations, such as fluorescent angiography, SD-OCT was used to monitor the condition monthly. Serous retinal detachment and retinoschisis gradually absorbed, and was almost fully absorbed 4 months after onset (fig. 2e, f). Her visual acuity recovered to 20/20. A yellow-orange lesion was observed in her right eye (fig. 2g) but not in her left eye (fig. 2h). The left eye also showed intrachoroidal cavitation; however, no incidence of retinoschisis or retinal detachment has been noted (fig. 2i, j).

Bottom Line: These were treated with intravitreal bevacizumab and then absorbed within 9 months.These were absorbed within 4 months without treatment.This case suggests that similar cases of cystoid macular edema after cataract surgery can occur, and that intrachoroidal cavitation is observed not only in eyes with pathologic myopia but also in normal eyes with peripapillary atrophy; intrachoroidal cavitation can cause macular detachment and retinoschisis.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology and National Hospital Organization, and Kyoto University Graduate School of Medicine, Kyoto, and Japan.

ABSTRACT

Purpose: To describe a patient with intrachoroidal cavitation in the normal eye that caused self-limiting recurrent macular detachment and retinoschisis.

Case report: An 80-year-old female patient with intrachoroidal cavitation in the normal eye presented with macular detachment and retinoschisis after cataract surgery. These were treated with intravitreal bevacizumab and then absorbed within 9 months. One year after cataract surgery, the patient presented with macular detachment and retinoschisis in the same eye again. These were absorbed within 4 months without treatment.

Conclusion: This case suggests that similar cases of cystoid macular edema after cataract surgery can occur, and that intrachoroidal cavitation is observed not only in eyes with pathologic myopia but also in normal eyes with peripapillary atrophy; intrachoroidal cavitation can cause macular detachment and retinoschisis.

No MeSH data available.


Related in: MedlinePlus