Edited Film

Filipe Henriques, Joana Providencia, Mariana Oliveira, Cristina Fonseca, Julia Fernandes, Rui Proença, Portugal

Purpose:
To describe the curious case of a progressive bilateral posterior uveitis of unkown etiology.

Methods:
A 57-year-old man was referred to our Oncology Department after two years of follow up at another Ophthalmology Center. The patient presented a progressive bilateral posterior uveitis resistant to medical treatment. He had already been submitted to several not successful treatment approaches, including antibiotics, corticosteroids and immunossupressors and was also submitted to a non-conclusive diagnostic vitrectomy. At our first observation, he had a best corrected visual acuity of counting fingers on his right eye and 4/10 on his left eye. On the slit lamp evaluation, we observed incipient cataracts bilaterally, with no significant anterior segment inflammation. On fundoscopy it was possible to observe macular subretinal deposits bilaterally and severe vitreous haze.

Results:
Assuming the low functional potential of the right eye and fearing a similar progression of the left eye, the treatment decision committee decided to perform a choroidal biopsy of the lesions of the right eye. Unfortunately, the first choroidal biopsy was not conclusive. On a last attempt, a new biopsy was performed, this time revealing an unexpected diagnosis.

Conclusion:
Invasive biopsies of the posterior segment may be indicated for rare instances where conventional methods are not conclusive, including persistent uveitis of unkown cause or some intraocular tumors. We describe a case in which a choroidal biopsy was the key to a surprising diagnosis, allowing to the treatment of the threatened fellow eye.

Contact Details:
Joana Providencia
CHUC
Coimbra
Portugal
Cell Phone : 912133742
Work Phone : 912133742
Email : Joanaprovidenciacosta@gmail.com