There is extensive chorioretinal scarring with optic atrophy in this patient who suffered severe blunt trauma 10 years earlier following a heroin overdose.
Vision is now counting fingers (CF), but thankfully, the other eye is normal with 20/20 acuity.
Note that the areas of intraretinal pigment migration mimic the bone spicules found with RP.
Learning Points:
Near total unilateral chorioretinal scarring has a relatively small differential diagnosis, including severe trauma, diffuse unilateral subacute neuroretinitis (DUSN), acute retinal necrosis syndrome (ARNS), and Saturday night retinopathy.
