Case Report Idiopathic Organ Transplant Chorioretinopathy after Liver Transplantation Maria Fernanda Abalem, Pedro Carlos Carricondo, Sergio Luis Gianotti Pimentel, and Walter Yukihiko Takahashi Retina and Vitreous Department, Universidade de S˜ ao Paulo, Brazil Correspondence should be addressed to Maria Fernanda Abalem; fernanda.abalem@gmail.com Received 25 January 2015; Accepted 10 March 2015 Academic Editor: Maurizio Battaglia Parodi Copyright © 2015 Maria Fernanda Abalem et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Idiopathic organ transplant chorioretinopathy is a rare disease associated with kidney and heart transplantation. We present a case secondary to liver transplantation including its multimodal imaging, diferential diagnosis, and physiopathology discussion. 1. Introduction Central serous chorioretinopathy (CSC) in the setting of solid organ transplantation (SOT), especially kidney, is a well-described condition. Although still poorly understood, it seems to be multifactorial, probably related to the use of corticosteroids and immunosuppressive agents, underlying disease and type of organ transplant received. Four distinct patterns have been described, based on fuorescein angiog- raphy (FA), including difuse retinal pigment epitheliopathy (DRPE), focal CSC, multifocal CSC, and CSC with bullous retinal detachment (RD) [1, 2]. Gass et al. described four cases of posterior idiopathic chorioretinopathy, another and broader spectrum of clinical fndings, in patients afer kidney and heart-lung trans- plantation. Te similarity among them was the presence of geographic zones of disruption and coarse clumping of the retina pigment epithelium (RPE), associated to RD [3]. We describe a case of idiopathic organ transplant chori- oretinopathy (IOTC) following liver transplantation, assessed by FA, indocyanine green angiography (ICG), fundus aut- ofuorescence (FAF), retinal optical coherence tomography (OCT), and enhanced depth imaging by spectral-domain OCT (EDI). 2. Case Report A 60-year-old man was referred to the Ophthalmology Department for assessment of progressive blurred vision in both eyes, in the past two years. He had a liver transplan- tation 3 years before, due to liver failure afer hepatitis C. He developed chronic arterial hypertension and mild renal insufciency as collateral efects of transplant medication. Tere were no medical records of transplant rejection. Te medication in use was acetylsalicylic acid (100 mg), anlodipine (5 mg), furosemide (40 mg), tacrolimus (1 mg), and mycophenolate mofetil (360 mg), all for three years. He also had a past history of corticosteroid use (5 to 10 mg) for 6 months afer the transplant. In the ophthalmological examination, he presented a corrected visual acuity of 20/200 in both eyes. Tere was no pupillary refex defect. Te biomicroscopy was unremark- able. Te fundoscopy (Figure 1) showed mild hypertensive retinopathy and mottled pigmentary changes in posterior pole. Te Spectralis SD-OCT (Heildelberg Engineering, Heildelberg, Germany) evidenced a serous macular detach- ment with protein-enriched fuid, without RPE detachment (Figure 2). Te EDI evidenced a thickened choroid (450 , measured subfoveal, from the outer border of RPE to the inner border sclera) with hyperrefective dots (Figure 3). FA Hindawi Publishing Corporation Case Reports in Ophthalmological Medicine Volume 2015, Article ID 964603, 5 pages http://dx.doi.org/10.1155/2015/964603