Retinal changes among pre-eclamptic patients in University of Benin Teaching Hospital, Benin, Nigeria

Background: Preeclampsia is one of the hypertensive disorders in pregnancy that contributes significantly to maternal and fetal morbidity and mortality, with the impact felt more in developing countries. It is characterized by endothelial dysfunction and vasospasm of vessels which can be observed by an ocular fundal examination. The aim of this study was to determine the ocular fundus findings of women with preeclampsia. Methods: This was a cross-sectional study, carried out at the University of Benin Teaching Hospital involving a total of 220 pregnant women. The women were divided into two groups of 110 pregnant women (A&B).Their Age and Gestational age was cross-matched and retinopathy graded according to Keith and Wagner classification. Group A was made up of Preeclamptic women and Group B was made up of healthy pregnant women. Visual acuity was measured using Snellens' chart, and the fundus was examined with direct ophthalmoscope. Results: This showed that the retinal changes observed in the preeclamptic women were associated with their age (P = 0.009), gestational age (P = 0.044), blood pressure (P = 0.001), Proteinuria (P = 0.001), Severity of the disease (P = 0.001), visual acuity (P = 0.035) as well as with the visual symptoms (P = 0.001) but not statistically significant with the gravida (P = 0.799). Conclusion: Our study highlights the importance of timely ophthalmoscopy which helps to assess severity of disease (pre-eclampsia) which affects the decision of induction of delivery to predict and prevent possible complications which in turn immensely helps in judicious management of disease. Also, the study revealed that preeclamptic women who are multigravida are more likely to have retinopathy than primigravid

Intraocular Pressure: Intravitreal Preservative-free Triamcinolone Injection in Diabetic Macular Edema and Branch Retinal Vein Occlusion

PURPOSE: To compare the intraocular pressure (IOP) in diabetic macular edema (DME) patients and macular edema associated with branch retinal vein occlusion (BRVO) patients after intravitreal preservative-free Triamcinolone injection.METHODS: This study included 36 patients diagnosed with DME and 44 patients diagnosed with BRVO with macular edema. Both groups were treated with intravitreal preservative-free Triamcinolone (Maqaid®, Wakamoto Pharmaceutical Co., Ltd., Tokyo, Japan) injection, and we compared the IOPs of the two groups determined before injection and at 1, 2, 3, and 6 months after injection. We also compared the IOP elevation ratios and durations, and central foveal thickness (CFT) changes using optical coherence tomography.RESULTS: In both groups, there was no statistical significance in the IOP before injection and at 1, 2, 3, and 6 months after injection. However, the IOP elevation ratio in the DME patients (38.9%) was significantly higher than that in the BRVO patients (15.9%) (p = 0.02). The duration of IOP elevation in the DME patients (1.14 ± 1.85 months) was significantly longer than that in the BRVO patients (0.30 ± 1.20 months) (p = 0.03). When the IOP was not controlled, we used IOP-lowering agents, and two patients in the DME were treated with glaucoma surgery. There was no statistical significance in the CFT before injection and at 1, 2, or 3 months after injection between the two groups (p = 0.72, p = 0.26, p = 0.66, p = 0.34, respectively). However, the CFT after 6 months was 328 ± 103 µm in the DME group and 434 ± 189 µm in the BRVO; this difference was significant (p < 0.01).CONCLUSIONS: Intravitreal injection of preservative-free Triamcinolone was effective in the treatment of both DME patients and macular edema patients associated with BRVO. Furthermore, Triamcinolone was more safely injected in macular edema associated with BRVO patients than in DME patients.

Bromfenac as Adjunctive Treatment with Intravitreal Bevacizumab in Branch Retinal Vein Occlusion of Macular Edema

PURPOSE: To evaluate the effectiveness of 0.1% topical bromfenac as an adjunctive treatment with intravitreal bevacizumab (IVB) injection for branch retinal vein occlusion (BRVO) patients.METHODS: We retrospectively evaluated 68 eyes of 68 patients with macular edema (ME) secondary to BRVO who were treated with IVB injection and followed up for at least 12 months. Of the 68 eyes, 38 were treated with IVB combined with 0.1% topical bromfenac and 30 were treated with IVB alone. IVB reinjection was performed in cases of recurrence. The primary outcome measurement was the number of IVB injections. Changes in the best-corrected visual acuity (BCVA) and central foveal thickness (CFT) during the 12-month follow-up were compared.RESULTS: There was no significant difference in the BCVA or CFT between the two groups at the initial and final examinations. However, the number of IVB injections was significantly lower in the 0.1% bromfenac-treated eyes (p < 0.01) than in the control eyes (4.1 ± 0.7 vs. 5.0 ± 0.6 times).CONCLUSIONS: Compared to IVB monotherapy, topical bromfenac as an adjunctive treatment with IVB injection of eyes with ME secondary to BRVO did not affect visual outcomes, but it reduced the number of IVB injections.

Non-glaucomatous Retinal Nerve Fiber Layer Defect Associated with Paravascular Inner Retinal Defect

PURPOSE: To report a case of non-glaucomatous retinal nerve fiber layer (RNFL) defect associated with paravascular inner retinal defect (PIRD) in a patient with idiopathic epiretinal membrane (ERM).CASE SUMMARY: A 70-year-old male who was diagnosed with ERM in his right eye and pseudoexfoliative glaucoma in his left eye visited our clinic. His intraocular pressure was 14 mmHg in both eyes while using topical hypotensive medications in both eyes. His right eye showed no glaucomatous change of the optic disc head, and also no glaucomatous visual field defect on standard automated perimetry. Red-free fundus photography and swept-source optical coherence tomography showed an ERM and wedge-shaped RNFL defect starting from the PIRD, not the optic disc head. He was diagnosed with non-glaucomatous RNFL defect in the right eye and was told to stop using topical hypotensive medication for the right eye. After 2 years of discontinuing the medication, the IOP was within the normal range, the RNFL defect showed no progression, and the visual field remained stationary.CONCLUSIONS: A non-glaucomatous RNFL defect can develop in association with PIRD in patients with idiopathic ERM. Examinations for PIRD as well as evaluation of the optic disc head are therefore necessary in patients with ERM and RNFL defect.

Comparison of Visual Acuity and Retinal Thickness According to Membranectomy in Idiopathic Epiretinal Membrane

PURPOSE: To compare the visual acuity and retinal thickness in patients with an idiopathic epiretinal membrane (ERM) after vitrectomy and membranectomy using two different methods.METHODS: This retrospective observational study included 77 eyes (32 eyes in the diamond-dusted membrane scraper [DDMS] group, and 45 eyes in the intraocular forceps [IOF] group) of 77 patients with idiopathic ERM who underwent pars plana vitrectomy and membranectomy. The main outcome measures were best-corrected visual acuity (BCVA, logMAR) and mean retinal thickness.RESULTS: In the IOF group, the BCVA at postoperative 1 week was significantly lower than at baseline and had improved at 12 weeks after surgery. In the DDMS group, the BCVA at postoperative 1 week showed no significant difference at baseline and had improved at 4 weeks after surgery. The central macular thickness at postoperative 6 months was significantly lower than at baseline (all, p < 0.001); there was no significant difference between the two groups (p = 0.400). The postoperative macular thickness of the DDMS group was significantly lower than that of the IOF group in the inner inferior and outer inferior areas at postoperative 12 weeks and 4 weeks (p = 0.046 and p = 0.039, respectively). Five eyes of the DDMS group and 15 eyes of the IOF group developed cystoid macular edema, 14 eyes of that improved without treatment.CONCLUSIONS: In patients with ERM, the use of DDMS or IOF for vitrectomy and membranectomy both resulted in improved visual acuity and decreased mean retinal thicknesses.

Retinal Ganglion Cell Layer Thicknesses and Visual Functions in Patients with Bilateral Temporal Optic Atrophy

PURPOSE: To investigate correlations between macular retinal ganglion cell (RGC) layer thickness and best-corrected visual acuity (BCVA) and visual field parameters in patients with bilateral temporal optic atrophy.METHODS: Thirty eyes of 15 patients with bilateral temporal optic atrophy and 30 eyes of 15 normal subjects that were age- and sex-matched were included in the study. We measured the thicknesses of the RGC layers of posterior poles using optical coherence tomography volume scanning. The RGC layer was divided into nine zones based on the Early Treatment of Diabetic Retinopathy Study baseline. Possible correlations of the RGC layer with the BCVA and visual field parameters were determined.RESULTS: The RGC layer thickness was significantly thinner in all patients compared to those in the control group (p = 0.001). The RGC layer thicknesses in the inner superior, inner temporal, inner inferior, and inner nasal areas were significantly correlated with the BCVA (r = −0.650, r = −0.626, r = −0.616, and r = −0.636, respectively; p = 0.000). The RGC layer thicknesses in the outer superior, outer temporal, outer inferior, and outer nasal areas were significantly correlated with the mean deviation of the visual field test (r = 0.470, r = 0.349, r = 0.496, and r = 0.469, respectively; p < 0.05).CONCLUSIONS: In patients with bilateral temporal optic atrophy, the RGC layer thickness in the medial region was correlated with the BCVA, and the RGC layer thickness in the lateral region was correlated with the mean deviation of the visual field test.

Retinal Toxicity Following the Injection Ganciclovir into Silicone Oil-filled Eye to Treat Acute Retinal Necrosis

PURPOSE: To report a case of retinal toxicity after an intravitreal ganciclovir injection to treat acute retinal necrosis in an eye filled with silicone oil.CASE SUMMARY: A 56-year-old male presented with ocular pain and visual loss in his right eye. His best-corrected visual acuity was 20/25, inflammatory cells in the anterior chamber, multiple retinitis lesions and retinal vessel occlusions in the peripheral retina and vitreous opacity were showed. Acute retinal necrosis was suspected, anterior chamber polymerase chain reaction (PCR) test was done. Aciclovir 2,400 mg/day intravenously and ganciclovir 2.0 mg were administered by intravitreal injection. After 4 days, retinitis was worsened and PCR test was positive for varicella zoster virus. Ganciclovir intravitreal injections were increased twice a week. After 16 days, retinal detachment occurred, so scleral encircling, vitrectomy, laser photocoagulation, and silicone oil tamponade were conducted. Ganciclovir 1.0 mg was injected at the end of surgery. The patient's visual acuity decreased to hand motion, and multiple crystal deposits with multiple retinal hemorrhages were observed in the right eye the next day. Visual acuity did not recover and optical coherent tomography showed that the macula was thinned.CONCLUSIONS: Visual loss seemed to be related with the retinal toxicity of ganciclovir. The increased local concentration due to the silicone oil tamponade is thought to have caused the toxicity.

Hierarchical Cluster Analysis of Peripapillary Retinal Nerve Fiber Layer Damage and Macular Ganglion Cell Loss in Open Angle Glaucoma

Association between Retinal Vascular Geometric Changes and Cognitive Impairment: A Systematic Review and Meta-Analysis

0.05). Similarly, no significant difference was detected in retinal arteriolar tortuosity (Z=0.91) and venular tortuosity (Z=1.31) (both p>0.05). However, the retinal arteriolar FD (mean difference: −0.03, 95% CI: −0.05, −0.01) and venular FD (mean difference: −0.03, 95% CI: −0.05, −0.02) were associated with cognitive impairment.CONCLUSIONS: A smaller retinal microvascular FD might be associated with cognitive impairment. Further large-sample and well-controlled original studies are required to confirm the present findings.

The Effect of Epiretinal Membrane on Dexamethasone Implant for Branch Retinal Vein Occlusion Macular Edema

PURPOSE: To evaluate the effect of epiretinal membrane (ERM) on the outcomes of intravitreal dexamethasone implant (Ozurdex®, Allergan, Irvine, CA, USA) treatment for macular edema (ME) secondary to branch retinal vein occlusion (BRVO). METHODS: Thirty eyes of 30 patients who received Ozurdex treatment for ME secondary to BRVO, and were followed-up for at least 6 months were retrospectively reviewed. Patients were divided into two groups based on the presence (ERM [+] or absence ERM [−]) of ERM at baseline. The best-corrected visual acuity (BCVA), central foveal thickness (CFT), recurrence of ME, and retreatment rate were evaluated at baseline, 1, 3, and 6 months after Ozurdex injection. RESULTS: Ten eyes of 30 eyes (33%) showed ERM at baseline. While the mean CFT was significantly reduced at 1 month after Ozurdex injection, it began to increase gradually thereafter in both groups. The ERM (+) group showed a significantly higher mean CFT than the corresponding values of the ERM (−) group at 1 (p = 0.022) and 6 months (p = 0.001) after Ozurdex injection. However, no significant difference was found in the BCVA between the two groups at every visit. The proportion of eyes with ME was significantly higher in the ERM (+) group (90%) than that in the ERM (−) group (35%) at 6 months after Ozurdex injection (p = 0.009). There were no significant differences between the two groups in the percentage of retreatment, time to retreatment, and type of materials used for retreatment. CONCLUSIONS: In patients with ME secondary to BRVO, the treatment effect of Ozurdex was low and the duration of treatment was short when ERM was concurrently present. However, the presence of ERM did not significantly affect visual outcomes after treatment with Ozurdex.

Subretinal Fluid Drainage through Original Breaks without Perfluorocarbon Liquid for Rhegmatogenous Retinal Detachment

PURPOSE: To evaluate the efficiency of a surgical method using original breaks to drain subretinal fluid without using retinotomy and perfluorocarbon liquid for patients with rhegmatogenous retinal detachment (RRD). METHODS: A retrospective chart review comparing 41 eyes of 41 patients who received vitrectomy, and used original breaks to drain subretinal fluid without using perfluorocarbon liquid, and 40 eyes of 40 patients who received vitrectomy using perfluorocarbon liquid for simple RRD between February 2014 and December 2017 was conducted. All patients were followed for a minimum of 6 months after surgery. RESULTS: The primary anatomical success percentages were 97.6% and 97.5% for groups that did not and did use perfluorocarbon liquid, respectively. Retinal detachment recurred in one eye from both groups. The final success percentage was 100%. The preoperative mean logMAR best-corrected visual acuity (BCVA) of 0.87 ± 0.80 improved to 0.30 ± 0.30 at postoperative 6 months for the group that did not use perfluorocarbon liquid, while it improved from 0.86 ± 0.71 to 0.42 ± 0.52 for the group that did use perfluorocarbon liquid. Both groups showed significant BCVA improvement (p < 0.01). There was no significant difference in the incidence of complications caused by the use of perfluorocarbon liquid. CONCLUSIONS: Using original breaks to drain subretinal fluid without perfluorocarbon liquid in cases with RRD may be an effective and safe surgical technique for functional and anatomical recovery without serious complications.

Retinal Nerve Fiber Layer and Macular Retinal Ganglion Cell Layer Thicknesses in Healthy Korean Children

PURPOSE: To measure the thicknesses of the circumpapillary retinal nerve fiber layer (RNFL) and macular retinal ganglion cell-inner plexiform layer (GCIPL) by optical coherence tomography (OCT) in healthy Korean children and adolescents. METHODS: Circumpapillary RNFL and macular GCIPL thicknesses were measured by OCT in 352 healthy eyes of 352 children and adolescents (child-adolescent group) aged 5–17 years and in 159 healthy eyes of 159 adults (adult group) aged 18-75 years. The difference in RNFL and GCIPL thicknesses between the groups and the effects of age and refractive errors on the measurements were evaluated. RESULTS: The mean age of the children and adults were 9.7 ± 3.6 and 44.7 ± 15.7 years, respectively. The mean of the average RNFL and GCIPL thicknesses were 103.1 ± 9.2 and 85.7 ± 4.6 µm, respectively, in the children group and 97.8 ± 8.2 and 82.9 ± 4.4 µm, respectively, in the adult group. The child-adolescent group had greater RNFL and GCIPL thicknesses compared to the adult group in all areas (p < 0.05) with the exception of the RNFL thickness in the temporal quadrant (p = 0.555). A thinner RNFL and thinner GCIPL were significantly associated with older age and greater myopia (p < 0.001). CONCLUSIONS: The mean RNFL and GCIPL thicknesses measured by OCT in the healthy eyes of children and adolescents were 103.1 and 85.7 µm, respectively. Children and adolescents had a thicker RNFL and GCIPL compared to adults.

Sjögren's Reticular Retinal Dystrophy

PURPOSE: To report a rare case of Sjögren's reticular retinal dystrophy. CASE SUMMARY: A 54-year-old male presented with blurred vision and metamorphopsia in both eyes since a few years prior to his initial visit. There was a bilateral reticular network of yellow deposits throughout the posterior pole on fundus examination, which was hyperautofluorescent in fundus autofluorescence photographs. The pigment alterations were more visible with fluorescein angiography, which showed hypofluorescent lesions with hyperfluorescent borders. Spectral-domain optical coherence tomography showed elevations of the outer retina associated with the presence of subretinal hyperreflective material. Based on the conclusive correlation with clinical features, we diagnosed Sjögren's reticular retinal dystrophy. CONCLUSIONS: Sjögren's reticular retinal dystrophy is characterized by its specific pigment changes at the level of clinical manifestations and the retinal pigment epithelium. In cases of Sjögren's reticular retinal dystrophy, close monitoring is required because it has a lifetime risk of choroidal neovascularization.

Subfoveal Choroidal Thickness Changes after Intravitreal Bevacizumab in Macular Edema Secondary to Retinal Vein Occlusion

PURPOSE: To determine changes in subfoveal choroidal thickness (SCT) after intravitreal injection of bevacizumab in eyes with macular edema secondary to retinal vein occlusion (RVO). METHODS: Forty-four patients treated with intravitreal bevacizumab for unilateral macular edema due to RVO were retrospectively reviewed. Before injection, patients underwent best-corrected visual acuity (BCVA) assessment, dilated fundus examination, fluorescein angiography, and enhanced depth imaging optical coherence tomography. Changes in BCVA, SCT, and central macular thickness (CMT) of the RVO eyes were evaluated and compared with those of the normal contralateral eyes at baseline and at 1, 3, and 6 months after injection. RESULTS: The mean SCT in RVO eyes (265.41 ± 43.02 µm) was significantly thicker than that in the fellow eyes (244.77 ± 30.35 µm) at baseline (p < 0.001). The mean SCT was significantly reduced at 1, 3, and 6 months after intravitreal bevacizumab injection (all p < 0.001), and the change in SCT was significantly correlated with the change in CMT (r = 0.327, p = 0.030). While there was an improvement in BCVA together with a reduction in SCT (p < 0.001), no significant correlation was found (p = 0.126). CONCLUSIONS: Subfoveal choroidal thickness in RVO eyes with macular edema was greater than that in the normal fellow eyes, and decreased significantly after intravitreal bevacizumab injection. The SCT reduction was significantly correlated with CMT reduction.

Interocular Symmetry of Optical Coherence Tomography Angiography Parameters in Normal Eyes of Korean Adults

PURPOSE: To evaluate the interocular symmetry of microvascular parameters measured by optical coherence tomography angiography (OCTA) in normal eyes of Korean adults. METHODS: We retrospectively reviewed the retinal microvascular structure of 91 healthy Korean subjects (182 eyes). We used OCTA to measure the area of the foveal avascular zone (FAZ), vessel density (VD), and perfusion density (PD) in both eyes. Intraclass correlation coefficients (ICCs), coefficients of variation (CVs), and Pearson correlation coefficients were calculated to evaluate the extent of agreement and correlations between binocular OCTA measurements. RESULTS: Both eyes had similar microvascular characteristics: FAZ area (right eye: 0.31 ± 0.11 mm², left eye: 0.30 ± 0.10 mm², p = 0.98), FAZ perimeter (right eye: 2.35 ± 0.45 mm, left eye: 2.36 ± 0.39 mm, p = 0.86). VD 1-mm center (right eye: 9.42 ± 2.75, left eye: 9.14 ± 2.96, p = 0.163), full area (right eye: 19.94 ± 1.65, left eye: 19.72 ± 1.76, p = 0.285), and PD 1-mm center (right eye: 0.16 ± 0.05, left eye: 0.16 ± 0.05, p = 0.151), full area (right eye: 0.36 ± 0.03, left eye: 0.36 ± 0.04, p = 0.716). All ICC values were above 0.8 and all CVs below 10%. CONCLUSIONS: The microvascular structure, as represented by the VD, PD, and FAZ area measured via OCTA, was bilaterally symmetric in normal eyes of Korean adults.

Utilizing a Previous Silicone Band Track in Recurred Retinal Detachment

PURPOSE: We report a case of utilizing a previous silicone band track in the reoperation of scleral encircling. CASE SUMMARY: An 8-year-old male presented with rhegmatogenous retinal detachment in the right eye. Five days after this diagnosis, he received scleral buckling surgery and cryopexy to seal the retinal tear. One month after surgery, a fundus examination showed subretinal fluid at the inferior site of the scleral buckle. He underwent scleral encircling surgery and a cryopexy procedure. The patient has had an uneventful postoperative course, and the retina has remained attached over a follow-up period of 9 months. However, exotropia and hypotropia developed in the right eye. Diagnosis of restrictive strabismus due to tissue adhesion around the silicone band was made. The encircling band was therefore removed and laser photocoagulation was performed 360° around the retina. Twenty-four hours after surgery, a fundus examination showed subretinal fluid. He received 360° scleral encircling surgery not using the 360° conjunctival peritomy. After confirming a previous encircling tract using #0-0 polydioxanone as a guide, #5-0 Nylon was tied to the end of the guide and inserted through the encircling tract with the end sutured with the silicone band. The silicone band was inserted into the encircling tract by pulling the #5-0 Nylon as a guide. Ophthalmoscopy revealed an attached retina with indentation of the scleral buckle at 360°. CONCLUSIONS: For reoperation in patients who previously underwent scleral encircling surgery, using the previous scleral encircling tract may be effective in cases with conjunctival and tissue adhesion.

Frosted Branch Angiitis Associated with Epstein-Barr Virus Infection

PURPOSE: To report a case of frosted branch angiitis (FBA) associated with Epstein-Barr virus (EBV) infection in a child. CASE SUMMARY: A 7-year-old boy presented with bilateral blurred vision. On ophthalmic examination, his best-corrected visual acuity was 20/25 in the right eye and 20/32 in the left eye. The pupils were equal, round, and reactive to light without a relative afferent pupillary defect. He had normal color vision in both eyes. Slit-lamp examination revealed no abnormalities in the anterior parts of the eyes. Fundoscopic examination revealed prominent white sheathing retinal vasculitis predominantly on the veins in all quadrants, as well as macular edema and irregular foveal reflex in both eyes. Fluorescein angiography showed normal blood flow, but late diffuse staining and leakage of the affected vessels. Spectral domain optical coherence tomography (SD-OCT) showed thickening of the vessel walls, swelling due to hyperreflective material, and hyperreflective retinal depositions. Serological tests and the serum polymerase chain reaction for EBV were positive. A diagnosis of FBA associated with EBV was made. He was treated with systemic acyclovir and steroids. The response was rapid, with improvement in visual acuity to 20/20 in both eyes by day 3. After 7 weeks, all clinical signs resolved and SD-OCT examination showed normal vessel wall thickness and the absence of hyperreflective depositions. CONCLUSIONS: EBV may present with FBA even in the absence of a systemic sign of primary EBV infection. Thus, EBV should be considered as the etiology of FBA.

Clinical Presentations of Focal Choroidal Excavation and Results of Long-term Follow-up

PURPOSE: To evaluate the clinical presentations of focal choroidal excavation and to report long-term outcomes of cases without retinal disorders at the initial presentation. METHODS: A retrospective review of medical records was performed for patients diagnosed with focal choroidal excavation. Concomitant retinal disorders at the initial presentation were identified. In cases without retinal disorders, the development of retinal disorders during follow-up was also evaluated. RESULTS: Forty-five eyes in 45 patients were examined in this study. Focal choroidal excavation was accompanied with retinal disorders in 16 eyes (35.6%). In the remaining 29 eyes, only focal choroidal excavation was noted without any accompanying retinal disorders. The accompanying retinal disorders included choroidal neovascularization (n = 8), central serous chorioretinopathy (n = 4), epiretinal membrane (n = 1), macular hole (n = 1), branch retinal vein occlusion (n = 1), and uveitis (n = 1). Of the 29 eyes without retinal disorders, 22 were followed up for a mean period of 33.5 ± 18.2 months. Consequently, choroidal neovascularization was found to have developed in one eye at 59 months, and subretinal fluid had developed in two eyes at 17 and 28 months, respectively. CONCLUSIONS: Focal choroidal excavation was accompanied by retinal disorders in 35.6% of the included patients. In patients without retinal disorders, the development of a retinal disorder was noted in some eyes, suggesting the need for long-term regular follow-up in patients diagnosed with focal choroidal excavation.

Central Serous Chorioretinopathy with Peripapillary Retinoschisis

PURPOSE: To report a case of central serous chorioretinopathy with peripapillary retinoschisis. CASE SUMMARY: A 64-year-old male presented with abnormal color vision of the left eye, which occurred 6 months prior to his visit. At the initial visit, a funduscopic examination revealed retinal elevation with suspected serous retinal detachment around the optic disc in the left eye. Spectral domain optical coherence tomography showed subretinal fluid on the nasal side of the optic disc and retinoschisis on the temporal side of the optic disc in the left eye. Fluorescein angiography revealed multiple leakages in the left eye. Indocyanine green angiography revealed choroidal vascular hyperpermeability in both eyes. Based on these results, the patient was diagnosed with chronic central serous chorioretinopathy and was treated with argon laser photocoagulation at the leakage points. After 8 weeks of laser therapy, optical coherence tomography indicated that there was no retinoschisis or subretinal fluid in the macula, nasal, or temporal sides of the optic disc. CONCLUSIONS: Peripapillary retinoschisis due to central serous chorioretinopathy improves with argon laser photocoagulation at leakage sites.

Primary Intraocular T-cell Lymphoma

PURPOSE: Intraocular lymphoma can be divided into primary and secondary usually involving B-cell lymphoma. Intraocular T-cell lymphoma is mostly secondary lymphoma while primary intraocular T-cell lymphoma is extremely rare. We report a case of primary T-cell lymphoma. CASE SUMMARY: A 62-year-old male without any systemic disease presented with a floater in the right eye. A fundus examination showed multiple whitish retinal infiltrations in the right eye. Intraocular lymphoma was suspected, and systemic examination was performed, but all results were normal. During steroid treatment, previous lesions were enlarged, new lesions developed, and a diagnosis of primary T-cell lymphoma was made by diagnostic vitrectomy. Consecutive intravitreal injections of methotrexate were performed. After eight injections, the vitreous and retinal lesions improved but we decided to terminate the injections due to corneal epitheliopathy. The corneal epitheliopathy was recovered and the patient is currently undergoing periodic follow-ups without progression of the lesion. CONCLUSIONS: Although intraocular T-cell lymphoma is a rare condition, this primary T-cell type should be considered when an intraocular lymphoma lesion is suspected.