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JAMA Ophthalmology Clinical Challenge
January 24, 2019

Monocular Crystalline Maculopathy in a Man in His 30s

Author Affiliations
  • 1Department of Ophthalmology, Medical University of Graz, Graz, Styria, Austria
JAMA Ophthalmol. Published online January 24, 2019. doi:10.1001/jamaophthalmol.2018.5534

A white man in his 30s employed as a metal worker presented with a 2-month history of slightly blurry vision in his right eye. He denied photopsia or floaters and did not note any visual field defects. His best-corrected visual acuity was 20/25 OD and 20/20 OS. He had no history of ocular trauma, drug use, or familial ocular diseases.

The anterior segment of both eyes was normal on slitlamp examination, but the fundus examination of the right eye showed multiple refractile small crystals scattered on the posterior pole (Figure 1A). Isolated crystals were also present in the vitreous core. Optical coherence tomography of the macula revealed the crystals to be located preretinally on the surface of the inner limiting membrane with sporadic crystals within the cortical vitreous (Figure 1B).

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