This 59YO male has a complicated ocular and medical history, including HIV/AIDS, prior cytomegalovirus (CMV) retinitis that was treated with a ganciclovir implant in the 1990s, multiple retinal detachment surgeries in his right eye, eventually leading to evisceration for a blind and painful eye, and a chronic macular hole in his left eye.
Color imaging shows a large macular hole surrounded by a rim of variable subretinal hyperpigmentation. Yellowish subretinal scarring from prior CMV retinitis is noted more inferiorly.
Swept-source OCT shows an unusual ball of deep retinal hyperreflectivity. En face OCT shows a unique perspective for this macular hole, including the hyperreflective deep retinal material.
