Video Presentation

A sub-retinal mystery

Video Details

First Author: S. R.Singh INDIA

Co Author(s):    M. Sharma   K. Aggarwal   V. Gupta                       

Abstract Details



Purpose:

We describe the role of multi-modal imaging in the diagnosis of cystic sub-retinal lesions and a minimally invasive technique for the management of such cases.

Setting:

Uveitis clinic of the Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India – A tertiary care referral centre in Northern India.

Methods:

We describe a case of an elderly male with decrease of vision in the right eye for one week. Detailed slit lamp examination revealed vitritis with a sub-retinal lesion along the infero-temporal arcade. Multi-modal imaging including but not limited to fundus fluorescein angiography (FFA), ultrasonography (USG) and enhanced depth imaging optical coherence tomography (EDI-OCT) helped in establishing the diagnosis. A minimally invasive 25-gauge pars plana vitrectomy approach was used to access and remove the cystic lesion in vivo.

Results:

Multi-modal imaging by USG and EDI-OCT revealed a sub-retinal cystic lesion with a hyper-reflective focus within it. A provisional diagnosis of sub-retinal cysticercosis was made. A 25-gauge pars plana vitrectomy followed by extraction of the cyst from the sub-retinal space done. The cyst was lysed and aspirated in vivo with the high speed cutting of the vitreous cutter. The fluidics of modern vitrectomy systems ensure complete removal of the inflammatory contents leading the minimal sequelae postoperatively. The patient achieved a good anatomical and functional visual outcome.

Conclusions:

Sub-retinal lesions can be effectively diagnosed with modern day multi-modal imaging platforms. Minimally invasive approach is ideal for the management of such lesions as it provides good visual outcomes with minimal post op morbidity.

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