Channels: Retina | Posted 11/19/2018
The patients was a 65-year-old Middle Eastern man who presented with a year long duration of vision loss in the affected eye. The other eye was normal. Visual acuity was hand motion only at 3 feet. The eye was quiet with no cells and only a trace of flare. There was an inferior exudative retinal detachment with shifting subretinal fluid, demonstrated in positional photos in the video. Careful examination under scleral depression showed no retinal breaks and no evidence of PVR. B scan ultrasonography showed choroidal thickening but no fluid in Tenon’s space, and no intraocular mass lesions. The patient was mildly hyperopic but not nanophthalmic. He was diagnosed with idiopathic uveal effusion syndrome and underwent scleral windows surgery with Mitomycin C. The video illustrates the procedure of making 90% depth scleral windows, excising the flaps and placing a Weck cell sponge with Mitomycin C over the bed for one minute. Unfortunately the patient’s retinal detachment persisted. After 6 months of no improvement he underwent vitrectomy, and upon drainage of sub retinal fluid was found to have significant sub retinal fibrosis which was extracted. At surgery there was still no detectable retinal break. The retina flattened, and silicone oil was instilled (This procedure not shown). It was concluded that he must have had a microscopic break in order to develop the sub retinal fibrosis. The retina remained attached but the vision declined to light perception only.
Mitomycin C, MMC • Retina • Sclera