Unilateral retinal crystalline deposition

Published:August 31, 2022DOI:
      A 71-year-old asymptomatic female was referred to a tertiary retina clinic for refractile changes in the left eye macula. Her past ocular history included panuveitis and cystoid macular edema OS secondary to HLA-B27 4 years prior. Her ocular inflammation and cystoid macular edema stabilized following 1 intravitreal dexamethasone injection. Visual acuity was 20/20 OU with no active ocular inflammation. Dilated fundus examination revealed fine crystalline deposits in the macula, sparing the retinal periphery OS (Fig. 1A, B). Swept-source optical coherence tomography of the macula OS demonstrated hyperreflective deposits at the vitreoretinal interface (Fig. 1C, D). This rare presentation represents asymptomatic crystalline vitreoretinal deposition in the setting of remote panuveitis and dexamethasone treatment.
      Fig 1
      Fig. 1(A) Bilateral fundus pseudocolour images of the posterior pole (Optos California) demonstrating a normal nerve, macula, periphery, and vessels in the right eye; (B) blunted reflex with multiple hyperreflective deposits localized in the macula of the left eye; (C) swept-source OCT (Topcon DRI Triton, Tokyo, Japan) of the macula and nerve OD demonstrating normal overlying vitreous and well-organized retinal layers with no choroidal pathology; (D) swept-source OCT OS demonstrating hyperreflective deposits throughout the vitreoretinal interface.
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