Clindamicina intravítrea como alternativa terapéutica en la toxoplasmosis ocular severa / Intravitreal clindamycin as a therapeutic alternative in severe ocular toxoplasmosis

La toxoplasmosis ocular es una enfermedad que puede tener graves consecuencias visuales. El objetivo es presentar un caso clínico de toxoplasmosis ocular bilateral severa en una paciente alérgica a sulfamidas en el que la reactivación monolateral de la enfermedad responde de forma favorable ante el tratamiento con clindamicina intravítrea y corticoterapia oral. Se muestra como la administración de clindamicina mediante inyecciones intravítreas semanales supone una alternativa terapéutica segura en aquellos casos de toxoplasmosis ocular severa y/o en los que existe contraindicación para el tratamiento clásico. La clindamicina intravítrea es una alternativa terapéutica segura con resultados clínicos favorables

Ocular toxoplasmosis is a disease than have severe consequences on the eyesight. The aim of this study article is to present a bilateral ocular toxoplasmosis in a sulfamide allergic patient with unilateral activation and her favourable progression with intravitreal Clindamycin and oral steroids treatment. Weekly intravitreal Clindamycin treatment is shown to be a suitable therapeutic alternative in cases of severe ocular toxoplasmosis and/or in patients with a contraindication to classical treatment. Intravitreal Clindamycin treatment is a safe alternative with favourable clinical results

Intravitreal clindamycin as a therapeutic alternative in severe ocular toxoplasmosis. / Clindamicina intravítrea como alternativa terapéutica en la toxoplasmosis ocular severa.

Ocular toxoplasmosis is a disease than have severe consequences on the eyesight. The aim of this study article is to present a bilateral ocular toxoplasmosis in a sulfamide allergic patient with unilateral activation and her favourable progression with intravitreal Clindamycin and oral steroids treatment. Weekly intravitreal Clindamycin treatment is shown to be a suitable therapeutic alternative in cases of severe ocular toxoplasmosis and/or in patients with a contraindication to classical treatment. Intravitreal Clindamycin treatment is a safe alternative with favourable clinical results.

Síndrome de la transiluminación iridiana aguda bilateral. A propósito de un caso clínico / Bilateral acute iris transillumination syndrome. A case report

OBJETIVO: Presentar el caso clínico de una paciente con el síndrome de la transiluminación iridiana aguda bilateral (BAIT). MÉTODOS: El síndrome de BAIT es una nueva entidad clínica caracterizada por una transiluminación iridiana, dispersión de pigmento en la cámara anterior y una pupila en midriasis media que no responde o es poco sensible a la luz debido a una parálisis del esfínter. Los pacientes con BAIT suelen presentar dolor ocular agudo, fotofobia y ojo rojo. DISCUSIÓN: Presentamos el caso clínico de una mujer de 53 años que, tras ser tratada de una infección del tracto respiratorio superior con moxifloxacino, desarrolló un síndrome de BAIT, diagnosticado en primera instancia de uveítis anterior aguda. CONCLUSIÓN: Este es, hasta donde se conoce, el primer caso reportado en Navarra, aunque es necesaria mayor casuística para establecer patrones claros acerca de esta enfermedad

OBJECTIVE: To present a case report of a patient with a bilateral acute iris transillumination syndrome (BAIT). METHODS: BAIT syndrome is a new clinical condition characterised by severe transillumination of the iris, acute onset of pigment dispersion in the anterior chamber, and a medial mydriatic pupil that is unresponsive or poorly responsive to light, due to a sphincter paralysis. Patients with BAIT generally present with acute ocular pain, photophobia, and red eyes. DISCUSSION: The case is presented of a 53 year-old woman, who, after being treated with moxifloxacin for an upper respiratory tract infection, developed a BAIT syndrome, which was initially diagnosed as acute anterior uveitis. CONCLUSION: As far as is known this is the first case reported in Navarra, but more case reports are needed to establish clear patterns about this condition

Bilateral acute iris transillumination syndrome. A case report. / Síndrome de la transiluminación iridiana aguda bilateral. A propósito de un caso clínico.

OBJECTIVE: To present a case report of a patient with a bilateral acute iris transillumination syndrome (BAIT). METHODS: BAIT syndrome is a new clinical condition characterised by severe transillumination of the iris, acute onset of pigment dispersion in the anterior chamber, and a medial mydriatic pupil that is unresponsive or poorly responsive to light, due to a sphincter paralysis. Patients with BAIT generally present with acute ocular pain, photophobia, and red eyes. DISCUSSION: The case is presented of a 53 year-old woman, who, after being treated with moxifloxacin for an upper respiratory tract infection, developed a BAIT syndrome, which was initially diagnosed as acute anterior uveitis. CONCLUSION: As far as is known this is the first case reported in Navarra, but more case reports are needed to establish clear patterns about this condition.

Ciclodiálisis traumática tratada con criopexia / Traumatic cyclodialysis treated with cryopexy

La ciclodiálisis es el resultado de la separación de las fibras longitudinales del músculo ciliar de su inserción escleral, creando estados de hipotonía ocular. Es causada principalmente por traumatismos. La gonioscopia ha sido tradicionalmente la prueba diagnóstica para esta entidad, sin embargo, en la actualidad está siendo sustituida por otras técnicas, como la biomicroscopía ultrasónica (BMU). Presentamos el caso de un varón de 57 años que tras sufrir un traumatismo en el ojo izquierdo con un disco de sierra radial, presentó perforación corneal y hemorragia vítrea con edema panretiniano. La gonioscopia fue normal a pesar de la existencia de hipotonía ocular persistente. La realización de una BMU permitió diagnosticar una pequeña ciclodiálisis, inferior de diez grados. El tratamiento quirúrgico permitió recuperar una presión intraocular normal (AU)

Cyclodialysis is the result of the separation of the longitudinal fibres of the ciliary muscle from their scleral insertion, creating states of ocular hypotony. It is mainly caused by traumatisms. Gonioscopy has traditionally been the diagnostic test for this entity, however, at present it is being replaced by other techniques, such as ultrasound biomicroscopy (UBM). We present the case of a 57-year-old male who, following a traumatism in the left eye caused by the disc of a radial saw, presented corneal perforation and vitreous haemorrhage with pan-retinal edema. The gonioscopy was normal in spite of the existence of persistent ocular hypotony. The realization of a UBM enabled diagnosis of a small cyclodialysis of less than ten degrees. Surgical treatment made it possible to recover normal intraocular pressure (AU)

[Traumatic cyclodialysis treated with cryopexy]. / Ciclodiálisis traumática tratada con criopexia.

Cyclodialysis is the result of the separation of the longitudinal fibres of the ciliary muscle from their scleral insertion, creating states of ocular hypotony. It is mainly caused by traumatisms. Gonioscopy has traditionally been the diagnostic test for this entity, however, at present it is being replaced by other techniques, such as ultrasound biomicroscopy (UBM). We present the case of a 57-year-old male who, following a traumatism in the left eye caused by the disc of a radial saw, presented corneal perforation and vitreous haemorrhage with pan-retinal edema. The gonioscopy was normal in spite of the existence of persistent ocular hypotony. The realization of a UBM enabled diagnosis of a small cyclodialysis of less than ten degrees. Surgical treatment made it possible to recover normal intraocular pressure.

Birdshot- like retinocoroidopatía como comienzo de la enfermedad de Whipple / Birdshot-like retinochoroidopathy as onset of Whipple's disease

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[Amniotic membrane transplantation with fibrin glue as treatment of refractory conjunctivochalasis]. / Injerto de membrana amniótica con adhesivo tisular en el tratamiento de la conjuntivocalasia refractiva.

CASE REPORT: A 63-year-old man with bilateral conjunctivochalasis presented with tearing, irritation, foreign body sensation and a delayed fluorescein clearance test. After no symptomatic improvement with topical treatment, surgery was carried out, with amniotic membrane transplantation and fibrin sealant. DISCUSSION: Conjunctivochalasis is a frequent disorder that shares symptoms with dry eye syndrome. When there is no response to topical treatment, surgical treatment is needed. The surgical technique described by Tseng, and based on amniotic membrane transplantation without suture, resulted in a very useful response, due to less inflammation and a rapid resolution and improvement of symptoms.

Injerto de membrana amniótica con adhesivo tisular en el tratamiento de la conjuntivocalasia refractiva / Amniotic membrane transplantation with fibrin glue as treatment of refractory conjunctivochalasis

Caso clínico: Paciente de 63 años que presenta una conjuntivocalasia bilateral con lagrimeo, picor, escozor y retraso en el aclaramiento de fluoresceína. Al no observarse mejoría sintomática con el tratamiento tópico, se interviene quirúrgicamente con implante de membrana amniótica sin sutura. Discusión: La conjuntivocalasia es una patología frecuente con síntomas comunes a la sequedad ocular. Cuando no hay respuesta al tratamiento médico se recurre al tratamiento quirúrgico. La técnica descrita por Tseng basada en el implante de membrana amniótica sin sutura resulta muy eficaz en estos casos debido a la poca inflamación que produce permitiendo una rápida recuperación y mejoría sintomática

Case report: A 63-year-old man with bilateral conjunctivochalasis presented with tearing, irritation, foreign body sensation and a delayed fluorescein clearance test. After no symptomatic improvement with topical treatment, surgery was carried out, with amniotic membrane transplantation and fibrin sealant. Discussion: Conjunctivochalasis is a frequent disorder that shares symptoms with dry eye syndrome. When there is no response to topical treatment, surgical treatment is needed. The surgical technique described by Tseng, and based on amniotic membrane transplantation without suture, resulted in a very useful response, due to less inflammation and a rapid resolution and improvement of symptoms

[Traumatic submacular hemorrhage treated with rt-PA and SF6]. / Hemorragia submacular traumática tratada con rt-PA y SF6.

CASE REPORT: This patient was afflicted by a traumatic submacular hemorrhage. A posterior vitrectomy was performed and intravitreal rt-PA and SF6 were administered. Four weeks later, the visual acuity had increased from 0.1 to 0.8. No complications due to the treatment with rt-PA were reported. DISCUSSION: It is known that waiting for the spontaneous blood removal in such cases results in a poor visual acuity recovery due to a toxic effect of the blood products. Both rt-PA and the SF6 are useful for the treatment of submacular hemorrhages secondary to age-related macular degeneration, and this case report has shown they are also useful to lyse traumatic blood clots, thus contributing to a better recovery of visual acuity.

Hemorragia submacular traumática tratada con rt-PA y SF6 / Traumatic submacular hemorrhage treated with rt-PA and SF6

Caso clínico: Paciente que presenta hemorragia submacular de origen traumático. Se realiza vitrectomía posterior y administración intravítrea de rt- PA y SF6. A las cuatro semanas la agudeza visual había pasado de 0,1 a 0,8. El paciente no presentó ninguna complicación derivada del tratamiento con rt-PA. Discusión: Debido a que la sangre es tóxica para la retina esperar a su reabsorción espontánea comporta una pobre recuperación visual. El rt-PA administrado junto al SF6 es útil para el tratamiento de hemorragias submaculares secundarias a degeneración macular asociada a la edad, pero también puede ser útil para la lisis de coágulos hemáticos traumáticos favoreciendo la recuperación de la agudeza visual

Case report: This patient was afflicted by a traumatic submacular hemorrhage. A posterior vitrectomy was performed and intravitreal rt-PA and SF6 were administered. Four weeks later, the visual acuity had increased from 0.1 to 0.8. No complications due to the treatment with rt-PA were reported. Discussion: It is known that waiting for the spontaneous blood removal in such cases results in a poor visual acuity recovery due to a toxic effect of the blood products. Both rt-PA and the SF6 are useful for the treatment of submacular hemorrhages secondary to age-related macular degeneration, and this case report has shown they are also useful to lyse traumatic blood clots, thus contributing to a better recovery of visual acuity

[Comparison of dynamic contour tonometry (Pascal) with pneumotonometry and Goldmann tonometry]. / Comparación del tonómetro Pascal con el neumotonómetro y el tonómetro Goldmann.

PURPOSE: To compare the intraocular pressure measurements as defined by the Pascal tonometer, the Goldmann tonometer and the pneumotonometer. METHODS: This was an observational clinical study, which included two hundred and five randomly selected subjects recruited from the Ophthalmology Department. The intraocular pressure measurements were performed with each tonometry technique in a randomized order. RESULTS: The Pascal's intraocular pressure measurement was significantly higher than that measured by the other two tonometers (p<0.05). The quality data of Pascal was: optimum in 27.3% (56 of 205 patients), acceptable in 42% (86 of 205 patients) and unacceptable in 23.4% (48 of 205 patients). In 7.3% (15 of 205 patients) it was impossible to obtain any measurement using Pascal. A weak correlation coefficient between the Pascal and the Goldmann, and between Pascal and the pneumotonometer was found. The Bland-Altman method of measurement using these tonometers showed a high degree of discordance. CONCLUSION: As reported by others authors, the Pascal's intraocular pressure measurement is higher than that of the Goldmann tonometer. The measurement differs from 0.7 to 4.4 mmHg. In corneas with pathology, it is very difficult or even unacceptable to measure the intraocular pressure using the Pascal tonometer.

Comparación del tonómetro Pascal(R) con el neumotonómetro y el tonómetro Goldmann / Comparison of dynamic contour tonometry (Pascal(R)) with pneumotonometry and goldmann tonometry

Objetivo: Comparar la medición de presión intraocular con el tonómetro de Pascal(R) en córneas normales frente al tonómetro de Goldmann y al pneumotonómetro. Método: Estudio clínico observacional en el que se han incluido 205 pacientes consecutivos y randomizados que han acudido a la consulta de oftalmología. Se realiza una medición con cada tonómetro en orden aleatorio. Resultados: El Pascal(R), dio una medición de la presión intraocular mayor que la del resto de tonómetros. Se obtienen diferencias significativas del Pascal(R) frente a los otros dos tonómetros (p<0,05). La fiabilidad del Pascal(R) fue: fiables en el 27,3% (56 de 205 pacientes), aceptable en el 42% (86 de 205 pacientes) y en el 23,4% (48 de 205 pacientes) inaceptable. En el 7,3% (15 de 205 pacientes) restante no se obtuvo ninguna medición con el tonómetro de Pascal(R). Al comparar el tonómetro de Pascal(R) frente al de Goldmann y al neumotonómetro se observa que el coeficiente de correlación es débil y presenta alta discordancia con el método de Bland- Altman. Conclusión: Diversos autores han comparado el tonómetro de Pascal(R) y el Goldmann coincidiendo todos en que el Pascal(R) ofrece una presión intraocular mayor que el Goldmann con unas diferencias que van de 0,7 a 4,4 mmHg. En córneas patológicas es muy difícil realizar la medición y cuando ésto ocurre ésta suele ser informada como inaceptable

Purpose: To compare the intraocular pressure measurements as defined by the Pascal(R) tonometer, the Goldmann tonometer and the pneumotonometer. Methods: This was an observational clinical study, which included two hundred and five randomly selected subjects recruited from the Ophthalmology Department. The intraocular pressure measurements were performed with each tonometry technique in a randomized order. Results: The Pascal(R)’s intraocular pressure measurement was significantly higher than that measured by the other two tonometers (p<0.05). The quality data of Pascal(R) was: optimum in 27.3% (56 of 205 patients), acceptable in 42%(86 of 205 patients) and unacceptable in 23.4% (48 of 205 patients). In 7.3% (15 of 205 patients) it was impossible to obtain any measurement using Pascal®. A weak correlation coefficient between the Pascal(R) and the Goldmann, and between Pascal® and the pneumotonometer was found. The Bland-Altman method of measurement using these tonometers showed a high degree of discordance. Conclusion: As reported by others authors, the Pascal (R)’s intraocular pressure measurement is higher than that of the Goldmann tonometer. The measurement differs from 0.7 to 4.4 mmHg. In corneas with pathology, it is very difficult or even unacceptable to measure the intraocular pressure using the Pascal (R) tonometer

[Optical coherence tomography in central retinal artery occlusion]. / Tomografía óptica de coherencia en oclusión de arteria central de la retina.

CLINICAL CASES: Three eyes with central retinal artery occlusion (CRAO) have been studied. Optical coherence tomography (OCT) was performed in each of them. Ophthalmoscopic signs of CRAO were equivocal in the three eyes. However, the presence of a hyporeflective signal in the OCT scan could be seen clearly in each of them. DISCUSSION: The presence of a hyporeflective band between the neurosensory retina and the retinal pigment epithelium in OCT images, that persist for several months after a CRAO episode, is useful in establishing the diagnosis in these patients.

Tomografía óptica de coherencia en oclusión de arteria central de la retina / Optical coherence tomography in central retinal artery occlusion

Casos clínicos: Presentamos tres ojos afectados de obstrucción de arteria central de la retina (OACR). En todos ellos realizamos exploración con tomografía óptica de coherencia (OCT). Dependiendo del tiempo de evolución del cuadro clínico, los signos oftalmoscópicos de OACR eran más o menos evidentes. Sin embargo, la presencia de una banda hiporreflectante en las imágenes de OCT pudo objetivarse en todos los casos. Discusión: La presencia en las imágenes de OCT de una banda hiporreflectante por debajo de la retina neurosensorial en los casos de OACR, que persiste incluso meses después del inicio del cuadro clínico, resulta útil en el diagnóstico de esta patología retiniana

Clinical cases: Three eyes with central retinal artery occlusion (CRAO) have been studied. Optical coherence tomography (OCT) was performed in each of them. Ophthalmoscopic signs of CRAO were equivocal in the three eyes. However, the presence of a hyporeflective signal in the OCT scan could be seen clearly in each of them. Discussion: The presence of a hyporeflective band between the neurosensory retina and the retinal pigment epithelium in OCT images, that persist for several months after a CRAO episode, is useful in establishing the diagnosis in these patients

[Thyroid ophthalmopathy: clinical activity determination of thyroid ophthalmopathy as a prognostic factor of immunosuppressive treatment response]. / Oftalmopatía tiroidea: determinación de parámetros de actividad clínica de la oftalmopatía tiroidea como factor pronóstico de respuesta al tratamiento inmunosupresor.

OBJECTIVE: To determine the usefulness of the clinical, biochemical and thyroid imaging parameters in patients with thyroid-associated ophthalmopathy, in predicting their response to immunosuppressive treatment. METHODS: This retrospective study of 16 patients with thyroid ophthalmopathy considered a number of variables including sex, age, thyroid hormone levels, treatment of the thyroid dysfunction, clinical activity score (CAS), severity (NOSPECS) of the ophthalmopathy, signs in standardized A-mode ultrasonography, in CAT and/or NMR, and previously used treatments and their effectiveness. RESULTS: The average age of the patients was 50.81 (S.D: 11.89) years; there were 5 males (31.3%) and 11 females (68.8%). The ophthalmopathy was classified as active in 10/16 patients (62.5%) and inactive in 6/16 (37.5%); and as moderate in 9/16 (56.25%) and severe in 7/16 (43.75%) according to the severity defined in NOSPECS. Ultrasonography was diagnostic in 100% of the cases. The severity decreased significantly (p < or =0.05), however the clinical activity decrease did not reach significance (p=0.38) during immunosuppressive therapy. Better results were obtained during treatment of patients with a higher CAS (p=0.04) and in those with more severe ophthalmopathy (p=0.02). There was a tendency for the patients with higher levels of TSI to respond better to the treatment (p=0.06). CONCLUSIONS: The CAS is the best parameter to quantify the activity of the disease and predicting the response to treatment. The higher the CAS and the more severe the ophthalmopathy, the better the response to treatment. No association existed between thyroid function and the activity or severity of the ophthalmopathy; or the effectiveness of treatment.

Oftalmopatía tiroidea: determinación de parámetros de actividad clínica de la oftalmopatía tiroidea como factor pronóstico de respuesta al tratamiento inmunosupresor / Thyroid ophthalmopathy: clinical activity determination of thyroid ophthalmopathy as a pronostic factor of immunosupressive treatment response

Objetivo: Determinar los parámetros clínicos, bioquímicos y de imagen que permitan conocer qué pacientes con oftalmopatía tiroidea van a responder al tratamiento y valorar su eficacia.Métodos: Estudio retrospectivo de datos apareados de 16 pacientes con oftalmopatía tiroidea. Se recogieron las variables: sexo, edad, tratamiento de la disfunción tiroidea, puntuación de actividad clínica (PAC) y de severidad (NOSPECS) de la oftalmopatía, niveles hormonales; signos ecográficos, en TAC y/o RMN; tratamientos empleados y eficacia de los mismos.Resultados: La edad media de la muestra fue de 50,81 (D.E.: 11,89) años; 5 varones (31,3%) y 11 mujeres (68,8%), con seguimiento medio de 6,4 meses. La oftalmopatía fue clasificada en activa en 10/16 pacientes (62,5% )e inactiva en 6/16 (37,5%); y en moderada 9/16 (56,25%) y leve 7/16 (43,75%) según criterios de severidad NOSPECS. La ecografía fue diagnóstica en el 100% de los casos.La severidad se redujo de modo significativo (p <= 0,05) mientras que la actividad clínica de forma no significativa (p=0,38). Se observó mejor respuesta al tratamiento en los pacientes con mayor PAC (p=0,04) y con oftalmopatía más severa (p=0,02). Existe tendencia a que los pacientes con mayores niveles de TSI respondan mejor al tratamiento (p=0,06).Conclusiones: La PAC es el mejor parámetro para cuantificar la actividad de la enfermedad y predecir la respuesta al tratamiento inmunosupresor.La PAC y la severidad de la oftalmopatía elevadas se asocian con mejor respuesta al tratamiento. No existe asociación de la función tiroidea con la actividad ni con la severidad de la oftalmopatía; la eficacia del tratamiento es independiente de la función tiroidea

Objective: To determine the usefulness of the clinical, biochemical and thyroid imaging parameters in patients with thyroid-associated ophthalmopathy, in predicting their response to immunosuppressive treatment. Methods: This retrospective study of 16 patients with thyroid ophthalmopathy considered a number of variables including sex, age, thyroid hormone levels, treatment of the thyroid dysfunction, clinical activity score (CAS), severity (NOSPECS) of the ophthalmopathy, signs in standardized A-mode ultrasonography, in CAT and/or NMR, and previously used treatments and their effectiveness. Results: The average age of the patients was 50.81 (S.D: 11.89) years; there were 5 males (31.3%) and 11 females (68.8%). The ophthalmopathy was classified as active in 10/16 patients (62.5%) and inactive in 6/16 (37.5%); and as moderate in 9/16 (56.25%) and severe in 7/16 (43.75%) according to the severity defined in NOSPECS. Ultrasonography was diagnostic in 100% of the cases. The severity decreased significantly (p <= 0.05), however the clinical activity decrease did not reach significance (p=0.38) during immunosuppressive therapy. Better results were obtained during treatment of patients with a higher CAS (p=0.04) and in those with more severe ophthalmopathy (p=0.02). There was a tendency for the patients with higher levels of TSI to respond better to the treatment (p=0.06). Conclusions: The CAS is the best parameter to quantify the activity of the disease and predicting the response to treatment. The higher the CAS and the more severe the ophthalmopathy, the better the response to treatment. No association existed between thyroid function and the activity or severity of the ophthalmopathy; or the effectiveness of treatment

[Silicone oil hypotonic maculopathy treatment]. / Aceite de silicona para el tratamiento de la maculopatía hipotónica.

CASE REPORT: We report a case of a man who developed hypotonic maculopathy after vitreoretinal surgery for anterior proliferative vitreoretinopathy. After an injection of intravitreal triamcinolone, the ocular pressure did not increase, therefore silicone oil was injected. After this, the visual acuity increased and the choroidal and retinal folds regressed. DISCUSSION: Hypotonic maculopathy is a frustrating problem, often resulting in poor visual acuity. There are not many effective treatments. The injection of silicone oil could be an alternative to increase the intraocular pressure and re-establish the normal anatomy of the eye, improving the visual acuity in some patients.

Aceite de silicona para el tratamiento de la maculopatía hipotónica / Silicone oil hypotonic maculopathy treatment

Caso clínico: Paciente con maculopatía hipotónica secundaria a vitrectomía posterior con liberación de proliferación vitreo-retiniana por desprendimiento de retina. Ante la falta de mejoría tensional a la inyección Triamcinolona intravítrea se inyectó aceite de silicona tras lo cual mejoró la agudeza visual y los pliegues coriorretinianos desaparecieron.Discusión: La maculopatía hipotónica es un proceso de mal pronóstico con deterioro visual profundo. Las opciones terapéuticas son limitadas. Creemos que la inyección de aceite de silicona es una opción terapéutica para restablecer la PIO y la anatomía normal del ojo, pudiendo mejorar, en algunos casos, la AV

Case report: We report a case of a man who developed hypotonic maculopathy after vitreoretinal surgery for anterior proliferative vitreoretinopathy. After an injection of intravitreal triamcinolone, the ocular pressure did not increase, therefore silicone oil was injected. After this, the visual acuity increased and the choroidal and retinal folds regressed. Discussion: Hypotonic maculopathy is a frustrating problem, often resulting in poor visual acuity. There are not many effective treatments. The injection of silicone oil could be an alternative to increase the intraocular pressure and re-establish the normal anatomy of the eye, improving the visual acuity in some patients