Vitreomacular Traction with Macular Edema
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80-year-old woman had vitrectomy surgery done in the right eye in 2007. Recently her vision in the left eye has been declining. She has had health problems. She had fluid on her lungs and had over a liter of fluid removed. She is recovering from that nicely. The vision has declined in the left eye and you suggested she come here for an evaluation.
VISUAL ACUITY: Vision OD is 20/160, OS is 20/80. IOP: OD 17, OS 14. The posterior chamber intraocular lens is in good position in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.5. There are patches of vitreoretinal traction around the macula.
OS: Vertical C/D ratio is 0.5. There are patches of vitreoretinal traction around the macula.
OCT SCAN: The OCT scan does show minimal retinal thickening in the left eye more than previously. The average thickness in the right eye is 242 microns and the left eye 355 microns.
PHOTOGRAPHS: Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAPHY: The FA shows unusual areas of peripheral hyperfluorescence corresponding to areas of eccentric vitreomacular traction and there is cystoid edema with staining in the macula in the left frame, but there is not differential staining of the optic nerve.
IMPRESSION:
1. PROBABLE TRACTIONAL CYSTOID MACULAR EDEMA – LEFT EYE
2. PERIPHERAL RETINAL EDEMA FROM VITREOMACULAR TRACTION – BOTH EYES
3. POOR VISION – RIGHT EYE
4. PREVIOUS VITRECTOMY – RIGHT EYE
DISCUSSION: I explained to the patient the vision in the left eye has declined from 20/40 down to 20/80. It does look like it is probably from vitreomacular traction. Still, there is a risk of surgery. This is her only eye and she is 80 years old. I suggest we start now with anti-inflammatory drops for a month to see if that will help her vision. If it does not, I will try a posterior sub-Tenon Kenalog injection. If that does not help, then I will probably suggest surgery.
I will keep you abreast of her progress. I have contacted the head of the company for microplasmin which would help her, and he said with the FDA process, it will not be available for at least a year or two.
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye607 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye500 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye420 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye436 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye450 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye444 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye392 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye401 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye424 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye438 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye480 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye401 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye471 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye389 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye413 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye402 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye438 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye455 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye430 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye439 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye459 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye462 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye392 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye421 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye431 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye441 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye513 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye471 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye485 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye487 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eye596 x angesehen80-year-old woman had vitrectomy surgery done in the right eye in 2007. Vision has been poor since despite a good anatomical result. Recently her vision in the left eye has been declining. The vision has declined in the left eye. Vision OD is 20/160, OS is 20/80
(0 Bewertungen)
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80-year-old woman had vitrectomy surgery done in the right eye in 2007. Recently her vision in the left eye has been declining. She has had health problems. She had fluid on her lungs and had over a liter of fluid removed. She is recovering from that nicely. The vision has declined in the left eye and you suggested she come here for an evaluation.
VISUAL ACUITY: Vision OD is 20/160, OS is 20/80. IOP: OD 17, OS 14. The posterior chamber intraocular lens is in good position in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.5. There are patches of vitreoretinal traction around the macula.
OS: Vertical C/D ratio is 0.5. There are patches of vitreoretinal traction around the macula.
OCT SCAN: The OCT scan does show minimal retinal thickening in the left eye more than previously. The average thickness in the right eye is 242 microns and the left eye 355 microns.
PHOTOGRAPHS: Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAPHY: The FA shows unusual areas of peripheral hyperfluorescence corresponding to areas of eccentric vitreomacular traction and there is cystoid edema with staining in the macula in the left frame, but there is not differential staining of the optic nerve.
IMPRESSION:
1. PROBABLE TRACTIONAL CYSTOID MACULAR EDEMA – LEFT EYE
2. PERIPHERAL RETINAL EDEMA FROM VITREOMACULAR TRACTION – BOTH EYES
3. POOR VISION – RIGHT EYE
4. PREVIOUS VITRECTOMY – RIGHT EYE
DISCUSSION: I explained to the patient the vision in the left eye has declined from 20/40 down to 20/80. It does look like it is probably from vitreomacular traction. Still, there is a risk of surgery. This is her only eye and she is 80 years old. I suggest we start now with anti-inflammatory drops for a month to see if that will help her vision. If it does not, I will try a posterior sub-Tenon Kenalog injection. If that does not help, then I will probably suggest surgery.
I will keep you abreast of her progress. I have contacted the head of the company for microplasmin which would help her, and he said with the FDA process, it will not be available for at least a year or two.
