Retina Rocks, the image bank of the Retina World Congress, is a free, open-source online image library whose mission is to help educate the world’s eye care providers about why the retina rocks!
| Image Gallery | Over 51,000 multimodal images |
| Reference Library | Over 14,000 annotated citations from the major eye journals |
| Cases Atlas | Over 1,600 case studies organized by disease entity |
| Access our Instagram feed @retina.rocks | |
| Wall of Fame | Look here for the best submitted cases and images |
Have a comment or question about today's case? Go to your favorite social media platform to join the conversation!
This healthy 30YO female was referred for asymptomatic retinal findings. Vision was 20/20 in her normal OD and 20/20 OS.
Optos color RGB imaging shows a dilated and tangled paired artery and vein extending into the nasal midperiphery. These vessels are hyporeflective on outer retinal swept-source OCT. Angiographically, the artery connects directly to the vein without leakage. On OCT, these anomalous vessels are hyperreflective and extend through the full-thickness retina.
Learning Points:
A retinal arteriovenous malformation (AVM) is a congenital connection between an artery and vein without an intervening capillary network. These lesions appear along a spectrum ranging from small, isolated lesions to the large ‘bag of worms’ appearance. These more extensive lesions are usually part of Wyburn-Mason syndrome, which includes ocular and midbrain vascular lesions. Although retinal AVMs are usually stable lesions, secondary venous occlusions may occur. Our patient has an isolated retinal AVM due to the lack of intracranial lesions on neurologic imaging.
Can J Ophthalmol. 2026 Oct;61(5):1181-1190. doi: 10.1016/j.jcjo.2026.04.006.
Post-uveal MM plaque 30 years post-surgery, fewer than 1 in 20 eyes retained useful VA. Results not altered after analyzing post-2010 patients within anti-VEGF era — Retrospective, 1785 Swedish patients
Objective: To quantify 30-year visual-acuity outcomes after ruthenium 106 or iodine 125 plaque brachytherapy for posterior uveal melanoma and identify independent predictors of best-corrected visual acuity (BCVA) <20/200.
Design: A retrospective single-centre cohort study.
Participants: Participants were 1 785 consecutive patients treated at St. Erik Eye Hospital (Stockholm, Sweden) from 1979 to 2024 (median follow-up 12.4 years).
Methods: Visual-acuity survival was estimated using Kaplan-Meier curves. Cumulative-incidence functions and multivariable Fine-Gray competing-risk regression modelled the risk of acuity <20/200. A 3-level FIT (fovea-isotope-thickness) score was derived and validated to stratify eyes into low-, medium-, and high-risk groups.
Results: Mean visual acuity declined from 0.34 logMAR (20/44) at diagnosis to 0.82 logMAR (20/132) at the last follow-up. Probabilities of maintaining acuity ≥20/200 were 64% (95% CI: 61-66) at 5 years, 40% (95% CI: 37-44) at 10 years, 18% (95% CI: 14-23) at 20 years, and 4% (95% CI: 1-11) at 30 years. Among eyes beginning with ≥20/40, corresponding probabilities were 73%, 52%, 26%, and 8%. Iodine 125 plaques (sHR [subdistribution hazard ratio]: 3.57 vs ruthenium 106; 95% CI: 2.43-5.23) independently predicted vision <20/200, while each additional millimetre of tumour-fovea distance was protective (sHR 0.90; 95% CI: 0.86-0.95). Neither prescribed apex dose nor anti-vascular endothelial growth factor-era treatment was associated with BCVA prognosis. Ten-year incidences of BCVA <20/200 were 24%, 49%, and 77% in low-, medium-, and high-risk FIT categories.
Conclusions: Three decades after plaque brachytherapy, fewer than 1 in 20 eyes retained useful vision. Iodine 125 plaques and tumours abutting the macula carried the greatest risk. The FIT score may assist clinicians in counselling and selecting sight-preserving strategies.
Receive Retina Rocks content in the RWC monthly newsletter!
Retina Rocks is the image bank of the Retina World Congress.
