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 eyevista 583 veces80-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 eyevista 462 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 403 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 425 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 430 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 421 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 368 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 376 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 393 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 414 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 456 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 380 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 449 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 372 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 388 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 371 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 410 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 428 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 403 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 406 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 437 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 439 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 366 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 403 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 416 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 422 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 489 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 454 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 464 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 465 veces80-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 votos)
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Vitreomacular traction with traction over retinal vessels in non-diabetic - Fluorescein leakage in areas of traction - Progressing vision loss left eyevista 565 veces80-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 votos)
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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.
