J Korean Ophthalmol Soc.  2009 Nov;50(11):1740-1744.

A Case of Isolated Choroidal Cystic Lesion With Good Visual Acuity

• Jeoung JK
• Cho YJ
• Yu HG
• Park SP

Abstract

PURPOSE
To report a case of isolated choroidal cystic lesion in the macula with no interval change for two years.
CASE SUMMARY
A 29-year-old woman who had suspicious maculopathy was referred to our clinic. Her best corrected visual acuity was 20/20 in the affected right eye, which showed a choroidal cystic lesion on a fundus exam, fluorescein angiography, USG and OCT. The multifocal ERG showed reduced amplitudes of the cystic area in the right eye, and SLO microperimetry revealed reduced retinal sensitivity in the cystic lesion as well as a stable fixation and spared foveal function. There was no evidence of underlying ocular disease in clinical assessment, and the lesion had not undergone interval change for the past two years.

Keyword

Choroidal Cyst

MeSH Terms

Adult
Choroid
Eye
Female
Fluorescein Angiography
Humans
Retinaldehyde
Visual Acuity
Retinaldehyde

Figure

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  Figure 1. (A) A 1.5 disc area-sized round mass lesion with surrounding hyperpigmentation was shown in the macula of the right eye. White glistening glial tissues overlaid the mass lesion. The peripheral retina of the right eye was normal. (B) Ultrasonography revealed that the mass was a cystic lesion with minimal internal echo signals.

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  Figure 2. Fluorescein angiography showed hypofluorescence due to macular pigmentation throughout the early and late period, but there was no leakage from the lesion.

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  Figure 3. OCT showed a hyperreflectivity of the overlying retina due to atrophy.

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  Figure 4. Initial Humphrey visual field test (central 30-2 threshold) shows paracentral scotoma in the right eye.

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  Figure 5. (A) Multifocal electroretinogram (mfERG) responses from the cystic mass were reduced in a 103 response density plot. However, the responses beyond the lesion were within normal range. (B) Averaged responses from the first three rings of the mfERG were reduced compared with those of the left eye.

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  Figure 6. SLO microperimetry in the right eye revealed that retinal sensitivity was markedly reduced at the cystic mass lesion in the right eye. The retinal sensitivity beyond the lesion was well-preserved and fixation instability was not observed.

Reference

References

1. Espinoza G, Rosenblatt B, Harbour JW. Optical coherence tomography in the evaluation of retinal changes associated with suspicious choroidal melanocytic tumors. Am J Ophthalmol. 2004; 137:90–5.

2. Benhamou N, Massin P, Hauchine B, et al. Macular retinoschisis in highly myopic eyes. Am J Ophthalmol. 2002; 133:794–800.

3. Theodossiadis GP, Theodossiadis PG, Ladas ID, et al. Cyst formation in optic disc pit maculopathy. Doc Ophthalmol. 1999; 97:329–35.

4. Espinoza G, Rosenblatt B, Harbour JW. Optical coherence tomography in the evaluation of retinal changes associated with suspicious choroidal melanocytic tumors. Am J Ophthalmol. 2004; 137:90–5.

5. Higashide T, Akao N, Shirao E, Shirao Y. Optical coherence tomo-graphic and angiographic findings of a case with subretinal toxocara granuloma. Am J Ophthalmol. 2003; 136:188–90.

6. Shields CL, Honavar SG, Shiel JA, et al. Circumscribed choroidal hemangioma: clinical manifestations and factors predictive of visual outcome in 200 consecutive cases. Ophthalmology. 2001; 108:2237–48.

7. Fukushima T, Hirakawa T, Tanaka A, Tomonaga M. Choroidal epithelial cyst of the prepontine region: case report and ultrastructural study. Neurosurgery. 1988; 22:128–33.