Floating Vitreous Cyst: Two Clinical Cases
A 78-year-old man was referred to the Eye Hospital because of vitreomacular traction in the left eye. He reported a slow visual deterioration in his left eye over the last 2 years, but had no problems with the right eye. Only when specifically asked, he reported transient blurring of vision in his right eye when changing head position. His medical history was unremarkable. The patient's best-corrected visual acuity was 0.5 in the right eye and 0.3 in the left eye. Slit-lamp examination showed nuclear cataract in both eyes, anterior segments were otherwise normal. Fundus examination of the right eye showed a big, round, semitranslucent, and partially pigmented vitreous cyst just below the inferior temporal vascular arcades (fig. ). The cyst appeared empty. During eye movements, the cyst was freely floating in the vitreous cavity. Inferior temporal retinoschisis was also noted in this eye, but there were no other changes of the fundus. Fundus examination of the left eye revealed significant vitreomacular traction. B-scan ultrasonography of the right eye showed partial PVD and a cystic, well-demarcated formation not fixed to any other ocular structures, with a diameter of 6 mm (fig. ). The cyst was evaluated also by SD-OCT. Images confirmed a thin, well-defined cyst wall with a hyporeflective lumen. Inside the cyst, small hyperreflective spots were present (fig. ). Blood serology tests were negative for Toxoplasma gondii, Toxocara canis, cysticercosis and Echinococcus. Observation was recommended as in the first case.