Recalcitrant Cystoid Macular Edema? Bilateral Intraretinal Hyporeflective Spaces on SD-OCT as a Presentation of a Pituitary Macroadenoma.

Andres Wu Lihteh Wu

Retin Cases Brief Rep 2020 Dec 18;Publish Ahead of Print. Epub 2020 Dec 18.

Asociados de Macula, Vitreo y Retina de Costa Rica San José, Costa Rica Illinois Eye and Ear Infirmary, University of Illinois School of Medicine, Chicago, Illinois, USA.

Purpose: To report a case of a pituitary macroadenoma that presented with bilateral intraretinal hyporeflective spaces located primarily in the inner nuclear layer in the macular SD-OCT.

Methods: Case report.

Results: Based on the findings of a macular SD-OCT, a 53-year-old man was considered as having cystoid macular edema secondary to a retinovascular condition. He was treated with intravitreal VEGF inhibitors and corticosteroids with no improvement. Confrontation visual fields suggested a bitemporal defect. MRI confirmed the presence of a non-secreting pituitary macroadenoma compressing the optic chiasm.

Conclusion: Not all intraretinal hyporeflective spaces in the OCT are secondary to a retinal vascular condition. Hyporeflective spaces in the INL on OCT imaging that do not leak on fluorescein angiography may be secondary to optic atrophy from chiasmal compression.

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