CENTRAL VISUAL PHENOMENA AS CLUES TO VITREOMACULAR TRACTION IN PATIENTS WITH NORMAL FUNDUS OCULI

To report two cases where the primary visual complaints were central visual phenomena, with normal fundus biomicroscopy.

History and clinical examination, fundus autofluorescence, and spectral domain-optical coherence tomography.

The authors report 2 patients, a 66-year-old woman and a 77-year-old woman, who complained of a central visual disturbance in one eye. Best-corrected visual acuity was normal. Ophthalmoscopy in the first case was unremarkable and showed minimal retinal pigment epithelial mottling in Case 2. Spectral domain-optical coherence tomography revealed vitreomacular traction with foveal distortion in both eyes, associated with small cysts in the inner retinal layers and in one patient disruption of photoreceptors.

Central visual phenomena are important clues for central vitreomacular traction, even in the presence of a normal fundus examination. The authors highlight the importance of performing spectral domain-optical coherence tomography evaluation in this setting before considering neurologic or systemic causes.