Angiographically Silent Macular Edema.
Aman in his late 70s presented with a 1 month history of blurry vision in his left eye. He reported fatigue,muscle stiffness, joint pain, anda 10 lbunintentionalweight loss.Onocular examination, his best corrected visual acuity was 20/25 OD and 20/60 OS. Anterior segment examination findings were unremarkable. Fundusexamination revealedbilateralmicroaneurysmsanddothemorrhages throughout the posterior pole, along with bilateral macular edema and serous neurosensory detachment in the left eye (Figure 1A) Optical coherence tomography of the right eye revealed severe cystoid macular edema, and fluorescein angiography showednormal fillingwithmultiplemicroaneurysms.Anoptical coherence tomographic imageof the left eye showed a large neurosensory detachment withoverlyingandsurroundingcystoidmacular edema. Fluorescein angiography of the left eye demonstrated hypofluorescence without pooling or leakage of fluorescein dye over the area of neurosensory detachment, which was persistent in later frames (Figure 1B) Quiz at jamaophthalmology.com Neurosensory detachment A Hypofluorescence and macular edema B
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