|Year : 2022 | Volume
| Issue : 1 | Page : 285-286
Pigmented mobile vitreous cyst with cystoid macular edema in retinitis pigmentosa - A quirky association
Rushik Patel, Kushal Delhiwala, Bakulesh Khamar, Parth Rana
Department of Vitreo Retina, Netralaya Superspeciality Eye Hospital, KD House, 1st Floor, Above Andhra Bank, Parimal Cross Roads, Ellisbridge, Ahmedabad, Gujarat, India
|Date of Submission||13-Apr-2021|
|Date of Acceptance||03-Jul-2021|
|Date of Web Publication||07-Jan-2022|
Dr. Kushal Delhiwala
Department of Vitreo Retina, Netralaya Superspeciality Eye Hospital, KD House, 1st Floor, Above Andhra Bank, Parimal Cross Roads, Ellisbridge, Ahmedabad - 380 006, Gujarat
Source of Support: None, Conflict of Interest: None
Keywords: Cystoid macular edema, pigmented vitreous cyst, retinitis pigmentosa
|How to cite this article:|
Patel R, Delhiwala K, Khamar B, Rana P. Pigmented mobile vitreous cyst with cystoid macular edema in retinitis pigmentosa - A quirky association. Indian J Ophthalmol Case Rep 2022;2:285-6
|How to cite this URL:|
Patel R, Delhiwala K, Khamar B, Rana P. Pigmented mobile vitreous cyst with cystoid macular edema in retinitis pigmentosa - A quirky association. Indian J Ophthalmol Case Rep [serial online] 2022 [cited 2022 Aug 14];2:285-6. Available from: https://www.ijoreports.in/text.asp?2022/2/1/285/334982
A 50-year-old female presented with blurring of vision in the right eye (OD) for the past 2 months. On examination, best-corrected visual acuity was 20/200 and 20/30 in OD and left eye, (OS) respectively. Slit-lamp evaluation of both eyes was unremarkable except posterior subcapsular cataract (OD > OS). Right eye fundus evaluation revealed a solitary, oval-shaped, smooth, and free-floating pigmented vitreous cyst (P-VC) in periphery, without signs of inflammation [Figure 1]a, [Figure 1]b, [Figure 1]c. The cyst was appreciated better using the red channel of pseudocolor ultra-widefield retinal imaging system (UWF-RIS; Optos, UK). Additionally, both eyes fundus showed waxy pale disc, attenuated retinal blood vessels, and bone spicule pigmentation in mid periphery, suggestive of typical retinitis pigmentosa (RP). Swept-source optical coherence tomography (DRI-OCT Triton plus, Topcon medical systems Inc., Oakland, NJ, USA) showed cystoid macular edema (CME) without associated epiretinal membrane (ERM) in OD [Figure 1]d. Ultrasonography (USG) of P-VC showed an approximate size of 3 mm × 2.2 mm with irregular internal echoes and hyperechogenic borders on A-scan vector overlay [Figure 1]e.
|Figure 1: (a) Ultra-widefield pseudocolor fundus photo of the right eye showing pigmented vitreous cyst (white arrow) and signs of retinitis pigmentosa. (b) Fundus photo showing movement of vitreous cyst from 5 o'clock hours to 3.5 o'clock hours (white arrow). (c) Magnified image of pigmented vitreous cyst. (d) Swept-source optical coherence tomography scan of the right eye showing cystoid macular edema. (e) B-scan ultrasonography of right eye vitreous cyst (asterisk) showing irregular internal echoes and hyperechogenic borders on A-scan vector overlay (+signs)|
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| Discussion|| |
Pigmented mobile vitreous cyst having irregular internal echoes, along with concurrent CME without ERM in RP, has not been described to the best of our knowledge.
In Tan et al.'s study of 2127 eyes with RP, ERM (709) and CME (255) were common. None had a vitreous cyst. Yoshida et al. found non-pigmented vitreous cysts in 37 of 867 eyes with RP. Of these, only two eyes had CME with ERM.
Vitreous cysts, including P-VCs, are known to have characteristic internal anechoic centers and hyperechoic borders on USG., In contrast, our patient with P-VC had irregular internal echoes.
Clinically, vitreous cysts with RP moved slightly on ocular motion. However, we could capture the gross mobility of the vitreous cyst during serial follow-ups with the help of pseudocolor UWF-RIS. Asymptomatic vitreous cysts, in general, rarely require intervention.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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