Frontiers in medicine · 2026
Case Report: A case of diffuse subretinal fibrosis and uveitis syndrome with vitreoretinal traction syndrome.
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Zhang Xiaohua, Hu Yongping, Li Jian
Аннотация
PURPOSE: This study aimed to report a case of diffuse subretinal fibrosis and uveitis (SFU) syndrome combined with vitreoretinal traction (VRT) syndrome, with a 4-year interval between the involvement of the two eyes in an elderly woman.
CASE DESCRIPTION: A 67-year-old woman presented with sudden, painless vision loss in her left eye for 20 days. The right eye had experienced blurred vision for more than 4 years without treatment. Best-corrected visual acuity (BCVA) was 0.02 in the right eye and 0.05 in the left eye. Anterior segment examination was unremarkable, with no signs of anterior inflammation or iris nodules in either eye. In the right eye, clumps of white deposits behind the intraocular lens (IOL) and granular white opacities in the vitreous were observed. Diffuse yellowish-white subretinal lesions of varying sizes were present throughout the fundus, extending from the posterior pole to the far periphery, accompanied by scattered areas of hyperpigmentation and depigmentation. The lesion boundaries were relatively well defined. In the left eye, flocculent vitreous opacities were observed, some of which were adherent to the retina. Hemorrhages and scattered small yellowish-white subretinal lesions were present in the posterior fundus. Retinal degeneration was also noted in the mid-peripheral retina. Comprehensive ophthalmologic and systemic examinations were performed. Fundus fluorescein angiography (FFA) revealed secondary neovascular membranes in the posterior pole of the retina. However, systemic evaluation did not reveal any significant abnormalities. The patient was diagnosed with bilateral SFU syndrome, VRT syndrome, and retinal neovascularization in the left eye. Pars plana vitrectomy and intraocular injection of triamcinolone acetonide were performed. Postoperatively, systemic glucocorticoids and immunosuppressive therapy were administered. After more than 1 year of follow-up, the macular edema recurred repeatedly, while the subretinal fibrosis remained largely stable. Ultimately, this study also attempted anti-vascular endothelial growth factor (VEGF) therapy for macular edema and achieved a partial therapeutic effect.
CONCLUSION: SFU syndrome is a rare condition. The present case demonstrated a 4-year interval between bilateral onset and was further complicated by VRT syndrome and retinal neovascularization, features that have not been previously reported. Glucocorticoids and immunosuppressive agents may delay or alleviate subretinal fibrosis to some extent; anti-VEGF therapy can provide therapeutic benefit for macular edema in this disease.
CASE DESCRIPTION: A 67-year-old woman presented with sudden, painless vision loss in her left eye for 20 days. The right eye had experienced blurred vision for more than 4 years without treatment. Best-corrected visual acuity (BCVA) was 0.02 in the right eye and 0.05 in the left eye. Anterior segment examination was unremarkable, with no signs of anterior inflammation or iris nodules in either eye. In the right eye, clumps of white deposits behind the intraocular lens (IOL) and granular white opacities in the vitreous were observed. Diffuse yellowish-white subretinal lesions of varying sizes were present throughout the fundus, extending from the posterior pole to the far periphery, accompanied by scattered areas of hyperpigmentation and depigmentation. The lesion boundaries were relatively well defined. In the left eye, flocculent vitreous opacities were observed, some of which were adherent to the retina. Hemorrhages and scattered small yellowish-white subretinal lesions were present in the posterior fundus. Retinal degeneration was also noted in the mid-peripheral retina. Comprehensive ophthalmologic and systemic examinations were performed. Fundus fluorescein angiography (FFA) revealed secondary neovascular membranes in the posterior pole of the retina. However, systemic evaluation did not reveal any significant abnormalities. The patient was diagnosed with bilateral SFU syndrome, VRT syndrome, and retinal neovascularization in the left eye. Pars plana vitrectomy and intraocular injection of triamcinolone acetonide were performed. Postoperatively, systemic glucocorticoids and immunosuppressive therapy were administered. After more than 1 year of follow-up, the macular edema recurred repeatedly, while the subretinal fibrosis remained largely stable. Ultimately, this study also attempted anti-vascular endothelial growth factor (VEGF) therapy for macular edema and achieved a partial therapeutic effect.
CONCLUSION: SFU syndrome is a rare condition. The present case demonstrated a 4-year interval between bilateral onset and was further complicated by VRT syndrome and retinal neovascularization, features that have not been previously reported. Glucocorticoids and immunosuppressive agents may delay or alleviate subretinal fibrosis to some extent; anti-VEGF therapy can provide therapeutic benefit for macular edema in this disease.