This patient with interstitial cystitis has deep bumps on OCT. Why?
Analysis
In this image, the inner portion of the retina is within normal limits. In the deeper retina, there is disruption of the ellipsoid zone and some increased hyper-reflectivity at the level of the RPE. This area corresponded to pigmentary changes on clinical examination and a reticular ring of hypofluorescence on angiography (video). The patient was noted to be taking Elmiron for her interstitial cystitis.
The patient was treated for Elmiron toxicity.
In this tip's accompanying 13 min. video, we'll review:
- How the differential diagnosis of RPE thickening
- The risk factor of elmiron on the macula
- The natural history of this toxicity
OCT Tip
In a patient with thickening of the RPE, consider toxic sources, including elmiron use.
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