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JAMA Ophthalmology Clinical Challenge
July 1, 2021

Bilateral Visual Acuity Loss in a 28-Year-Old Man With Duchenne Muscular Dystrophy

Author Affiliations
  • 1Department of Ophthalmology, Geneva University Hospitals, Geneva, Switzerland
JAMA Ophthalmol. Published online July 1, 2021. doi:10.1001/jamaophthalmol.2020.6852

A 28-year-old man with Duchenne muscular dystrophy (DMD) presented with a recent bilateral and painless decrease of best-corrected visual acuity to light perception OD and counting fingers OS. Results of a slitlamp examination showed iris neovascularization and posterior subcapsular cataract in the right eye and no anterior segment abnormalities, including no iris neovascularization, in the left eye. Intraocular pressure was 60 mm Hg in the right eye and 14 mm Hg in the left eye. The fundus in the right eye (Figure, A) showed a total retinal detachment with hemorrhagic prepapillary fibrosis reaching up to the posterior capsule; the left eye (Figure, B) showed peripapillary tractional retinal detachment with proliferative vitreoretinopathy, retinal neovascularization, and vitreous hemorrhage. Fluorescein angiography showed extensive retinal capillary and arteriolar nonperfusion and peripapillary neovascularization in both eyes.

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