Pseudohypopyon of cholesterol crystals occurring 16 years after retinal detachment in x-linked retinoschisis

Background: Cholesterol crystals of the anterior chamber can be found as a marked feature of advanced cholesterosis bulbi; typically following i.o. hemorrhage after severe trauma, retinal detachment or M. Coats. Case report: A 39-year-old male patient with longstanding (16 years) retinal detachment in his right eye due to x-chromosomal linked retinoschisis presented with a clinical picture of a hypopyon and mature cataract. Ultrasonography showed a retrolental mass. Phacolytic uveitis was suspected and pars plana lentectomy and vitrectomy was performed. Intraoperatively subretinal chrystals could be detected. A specimen of the aqueous humor and subretinal fluid was evaluated biochemically and histologically and revealed cholesterol crystals. Conclusions: Cholesterosis bulbi may be similar to lentogenic uveitis and should be included in the differential diagnosis of such processes. To our knowledge this is the first case of cholesterol crystals of the anterior chamber sixteen years after retinal detachment in x-linked retinoschisis.