A 51-year-old presented 1 month following scleral fixation of intraocular lens (IOL). There was history of persistent low intraocular pressure, choroidal detachment, and vitreous hemorrhage immediately following surgery. While corrected visual acuity was 6/60, examination revealed multiple vertically oriented pigmented lines near fovea [Fig. 1a] with peripheral vitreous hemorrhage. Optical coherence tomography (OCT) showed discontinuous outer retinal layers at fovea [Fig. 1b], leading to a diagnosis of hypotonic maculopathy. One month later, visual acuity improved to 6/18 and OCT showed improvement in continuity of foveal outer retinal layers [Fig. 1c]. With resolution of vitreous hemorrhage, a large circumferential choroidal fold was now apparent inferiorly [Fig. 1d].
Figure 1.
(a) Fundus photograph showing multiple vertically oriented closely spaced old chorioretinal folds temporal to the fovea (arrows). (b and c) Sequel optical coherence tomography images showing improvement in the continuity of foveal outer retinal layers. The alterations in outer retinal layer reflectivity (arrows) improved in the region of the folds too. (d) Ultra-wide field fundus photograph showing a giant circumferential chorioretinal fold in the inferior quadrants (arrowheads), extending beyond the equator nasally and marked by loss of pigment at its summit. Grayish folds are seen temporal to the fovea (star)
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