-: In this video, we discuss a case
of an intravitreal lesion in the vitreous
cavity of a young female.
A 42-year-old young lady presented
with decreased vision in her right eye
for the last two months.
Her vision was recorded at 6/60 in the right eye.
Posterior segment examination revealed the
presence of vitritis.
There was a translucent, yellowish, free-floating lesion in
the vitreous cavity along with inferior preretinal fibrosis
and occlusive vasculitis.
OCT scan of the right eye showed mild macular traction
and a lamellar macular hole.
A complete blood picture showed mild eosinophilia.
This was very suggestive of intravitreal cysticercosis.
Further neuroimaging confirmed neurocysticercosis
in an MRI scan of the brain.
The patient was taken up
for transconjunctival 23-gauge 3-port
pars plana vitrectomy.
A core vitrectomy was done with the removal of vitreous
around the lesion, and then the cyst was removed using a
vitreous cutter.
Following this, the posterior hyaloid face was stained
with triamcinolone acetate
and removed carefully without causing retinal breaks.
Blue dye was injected
to stain the internal limiting membrane,
following which the stump
of residual fibrous tissue was removed from around the disc
and the internal limiting membrane peel was then done,
sparing the fovea to avoid any undue stress on the fovea.
Fluid-air exchange was completed,
and endolaser around the clinically evident areas
of vasculitis characterized by sheathing
of the retinal blood vessels was conducted
before the case concluded.
Postoperative follow-up at 6 weeks shows a fully attached
retina and visual improvement to 6/9 unaided.
OCT scan shows improved foveal contour.
A 6-month review showed stable ocular findings.
The patient is currently under the care
of a specialist in infectious diseases
who is overseeing treatment
for the neurological involvement.