This 55YO diabetic male presented with 2 months of bilateral vision loss. Vision was 20/80 OD and 20/120 OS.
Pseudocolor SLO ultrawidefield imaging of his left eye shows moderate asteroid hyalosis, with larger condensed stands of material obscuring the underlying macula. Spectral domain OCT scanning shows complex variable vitreous traction on the disc and macula with a small foveal detachment. The asteroid particles appear as hyperreflective vertical lines resembling falling rain.
Learning Points:
Examining the fundus in a patient with dense asteroid, as in this diabetic patient, can be extremely challenging. Fluorescein angiography and OCT are great modalities because they can visualize the retina when the clinical exam can’t. In our patient’s case, the OCT revealed foveal traction, indicating the need for vitrectomy surgery.
