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Iatrogenic retinal damage and vitreous hemorrhage secondary to YAG laser

Published:August 31, 2022DOI:https://doi.org/10.1016/j.jcjo.2022.08.003
      A 64-year-old female presented with a vitreous opacity causing significant visual disturbance in her right eye. YAG vitreolysis was performed, resulting in iatrogenic retinal damage and vitreous hemorrhage. The patient was referred for assessment and subsequently underwent a right eye vitrectomy. Ultra-wide-field pseudocolour imaging of the right eye (Fig. 1A) shows preoperative vitreous hemorrhage. Intraoperative imaging (Fig. 1B) demonstrates an inferior retinal hole with adjacent intraretinal hemorrhage. Postoperative ultra-wide-field pseudocolour imaging of the right eye (Fig. 1C, green line) corresponds to the spectral-domain optical coherence tomography (Fig. 1D). This demonstrates a retinal hole with central hemorrhage, disruption of the ellipsoid zone and retinal pigment epithelium, and adjacent hyperreflectivity of the outer retinal layers.
      Fig 1
      Fig. 1Right eye retinal imaging: (A) Ultra-wide-field pseudocolour imaging showing preoperative vitreous hemorrhage; (B) intraoperative imaging showing an inferior retinal hole; (C) Postoperative ultra-wide-field pseudocolour imaging (green line) corresponding to (D) spectral-domain optical coherence tomography demonstrating disruption of the ellipsoid zone and retinal pigment epithelium with adjacent hyperreflectivity of the outer retinal layers.
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