Systemic and topic corticosteroids Non steroidal anti- inflammatory drops Transient decrease of macular edema of RE 1 intravitreal injection of triamcinolone in each eye BCVA RE and LE: ↑ to 20/25 In the last visit the patient had recurrence of macular edema in the LE In conjunction with gastroenterologist, immunosuppressive therapy was increased and we are considering submit the patient to Ozurdex® Crohn disease (CD) is primarily considered an inflammatory condition of the small and large intestine, although associated extraintestinal inflammation is relatively common. Extra-intestinal manifestations of CD occur in one third of patients. Ocular complications are infrequent, occurring in less than 10% of cases, but can be associated with significant morbidity. Ocular manifestations are generally localized to the anterior chamber and ocular surface but rarely can involve the posterior pole, orbit, and optic nerve. This case is probably a rare example of posterior segment manifestation in CD. We are not sure if this is of autoimmune etiology or an independent vascular disease of ischemic etiology. Other diagnostic tests, including study of systemic vessels are essential for guiding diagnosis and future treatment. Sílvia Monteiro MD, Inês Casal MD, Ana Figueiredo MD, Carolina Vale MD, Maria João Furtado MD, Angelina Meireles MD Ophthalmology Department, Centro Hospitalar do Porto, EPE, Porto, Portugal Department Director: Pedro Menéres MD We report a case of a 61-years-old white man with the diagnosis of CD since five years ago. He was under systemic treatment with azathioprin, adalimumab and salazopirin. The patient did not have diabetes mellitus or arterial hypertension. He had history of an uneventful cataract surgery of both eyes in our institution and had no other relevant ophthalmological history. Two months after the cataract surgery of right eye (RE) he presented with decreased visual acuity of right eye (RE) from 20/30 to 20/60. One month after the cataract surgery of left eye (LE), the visual acuity of LE also decreased from 20/25 to 20/60. Anterior segment and IOP: normal Fundus examination: extremely tortuous retinal vessels, and arteriovenous crossing changes on both eyes. No signs of vasculitis or vitritis. OCT: exuberant cystoid macular edema of both eyes. Fluorescein angiography: vascular tortuosity, macular edema with fluorescein leakage in macular zone; some ischemic areas on posterior pole of both eyes. Carotid doppler was normal. Serum complement and immunoglobin levels were normal and no autoantibody was detected. All viral studies, quantiferon-TB, VDRL, TPHA, and other biochemical studies (angiotensin converting enzyme and plasma lipid levels included) were negative.