A 58-year-old woman returned from the Ukraine with 3 months of constant blurry vision in the left eye. Her history was significant for glaucoma and breast cancer with brain metastasis treated with CyberKnife and whole-brain radiation. While abroad, she received 2 inferiorly placed periocular steroid injections and was treated with glaucoma drops for elevated pressures of 55 mm Hg. At presentation, her visual acuity was 20/20 OD and 20/50 OS, and intraocular pressures were 18 and 20 mm Hg, respectively. She had a left afferent pupillary defect and left superior visual field deficit. Slitlamp examination of the right eye was unremarkable, while the left eye showed 1+ cell in the anterior chamber and 1+ nuclear sclerosis with pigment on the anterior lens capsule. Posterior examination revealed 2+ whitish vitreous deposits, a cup-disc ratio of 0.8, and inferior retinal detachment with subretinal particulate material (Figure, A). B-scan showed vitreous, subhyaloid, and subretinal opacities without choroidal involvement (Figure, B). A magnetic resonance image of the brain and orbits did not reveal any new metastatic lesions.
Garg PG, Simonett JM, Fawzi AA. White Vitreous Deposits After Subtenon Steroid InjectionMore Than Meets the Eye. JAMA Ophthalmol. Published online February 09, 2017. doi:10.1001/jamaophthalmol.2016.4192