Dr. Anjali Maheshwari

DR. AGRIMA BHATIA, Dr.Hs Trehan

Abstract

A 65-year-old male with unilateral exudative retinal detachment with leopard spot retinopathy and shallow choroidal detachment in both eyes was thoroughly evaluated keeping in mind all the differential diagnoses including multifocal CSCR, intraocular lymphoma, secondaries from a primary tumor, posterior scleritis and uveal effusion syndrome. He underwent FFA, OCT, USG B Scan, Ultrasound biomicroscopy all of which showed presence of exudative retinal detachment in right eye and shallow choroidal detachment in both eyes. He also underwent PET scan which was suggestive of a prostatic malignancy and was subsequently excluded. To rule out Intraocular lymphoma, the patient underwent vitreous biopsy and transscleral subretinal fluid drainage during which an unexpected iatrogenic break was induced following which he underwent vitrectomy. The approach to the case, dilemmas and management issues associated with the unexpected outcomes are discussed in detail.