Tophi on the Retina: An Intraocular Manifestation of Gout

The fundus of a 37-year-old man with retinitis pigmentosa revealed crystal-like materials near the optic nerve (Fig A) in his right eye. The left fundus view was hazy from (Fig B) a grey vitreous hemorrhage. OCT angiography showed no blood flow in the crystalline deposits (Fig C). He had a 10-year history of poorly controlled chronic gout. He suffered a recurrent vitreous hemorrhage in the left eye 15 days later. After clearing the hemorrhage, we found crystal-like materials on the retinal surface (Fig D) and removed them during vitrectomy.