J Korean Ophthalmol Soc.  2018 Aug;59(8):790-796. 10.3341/jkos.2018.59.8.790.

Pars Plana Vitrectomy for Cystoid Macular Edema in a Retinitis Pigmentosa Patient

• Choi YJ
• Shin MH
• Han YS
• Seo SW
• Yoo JM
• Chung IY

• KMID: 2418508
• DOI: http://doi.org/10.3341/jkos.2018.59.8.790

Abstract

PURPOSE
To report the first case of cystoid macular edema in a retinitis pigmentosa patient with pars plana vitrectomy.
CASE SUMMARY
A 43-year-old female visited our hospital with visual disturbances of both eyes. Corrected visual acuity was 20/22 in the right eye and 20/25 in the left eye. Peripheral depigmentation and atrophy of the retinal pigment epithelium, pigmentary retinal degeneration, and attenuated arterioles were observed in both eyes. Cystoid macular edema was observed on optical coherence tomography which showed that the central macular thickness was 308 µm in the right eye and 422 µm in left eye. Intravitreal aflibercept was injected into the left eye. One month after injection, the central macular thickness showed no response with a thickness of 449 µm. An intravitreal dexamethasone implant was then injected, 1 month after injection, the central macular thickness was 367 µm. Six months after injection, the patient again complained of visual disturbance of the left eye with a corrected visual acuity of 20/70. Vitreous opacity was observed and the central macular thickness was 501 µm. The patient underwent pars plana vitrectomy. Three days after surgery, the central macular thickness was 320 µm. One year after surgery, the corrected visual acuity was 20/33 and the central macular thickness was 311 µm.
CONCLUSIONS
Pars plana vitrectomy due to cystoid macular edema in a retinitis pigmentosa patient has not been previously reported in the Republic of Korea. Pars plana vitrectomy can therefore be an effective treatment for cystoid macular edema in retinitis pigmentosa patients.

Keyword

Central macular thickness; Cystoid macular edema; Pars plana vitrectomy; Retinitis pigmentosa

MeSH Terms

Adult
Arterioles
Atrophy
Dexamethasone
Female
Humans
Macular Edema*
Republic of Korea
Retinal Degeneration
Retinal Pigment Epithelium
Retinitis Pigmentosa*
Retinitis*
Tomography, Optical Coherence
Visual Acuity
Vitrectomy*
Dexamethasone

Figure

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  Figure 1 Fundus photograph at first visit. Fundus photograph shows peripheral depigmentation and atrophy of retinal pigment epithelium, pigmentary retinal degeneration, attenuated arterioles in both eyes.

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  Figure 2 Optical coherence tomography scan showing cystoid macular edema in both eyes. (A) Central macular thickness in right eye: 308 µm. (B) Central macular thickness in left eye: 422 µm.

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  Figure 3 Visual field showing tunnel vision of peripheral visual loss in both eyes. (A) Visual field index was noted in right eye: 36%. (B) Visual field index in left eye: 37%.

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  Figure 4 Preoperative (2 months after bevacizumab and triamcinolone injection) fundus photograph. Fundus photograph shows vitreous opacity in left eye.

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  Figure 5 Optical coherence tomography. (A) 1 month after aflibercept injection. (B) 1 month after dexamethasone implant injection. (C) Revisitation due to visual loss. (D) 2 months after bevacizumab and triamcinolone injection. (E) 3 days after pars plana vitrectomy. (F) 1 year after pars plana vitrectomy.

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