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Ophthalmic Images
June 14, 2018

Pseudohypopyon in Adult-Onset Foveomacular Vitelliform Dystrophy

Author Affiliations
  • 1Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
JAMA Ophthalmol. 2018;136(6):e180760. doi:10.1001/jamaophthalmol.2018.0760

A man in his late 40s with poor vision in the left eye from a remote, traumatic retinal detachment presented with gradual decreased vision in the right eye. Visual acuities were 20/30 OD and hand motions OS. Fundus examination of the right eye (Figure, A) revealed a central macular lesion with yellow material gravitating inferiorly, consistent with pseudohypopyon. Optical coherence tomography (Figure, B) confirmed this finding, also demonstrating disruption of the inner segment–outer segment junction. When the patient presented years earlier for retinal detachment, examination results of the right fundus were unremarkable. Therefore, a diagnosis of adult-onset foveomacular vitelliform dystrophy was made. The patient was observed, and vision has remained stable after 2 years of follow-up. This case represents an example of a large pseudohypopyon, more commonly seen in Best disease.

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