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This healthy 20YO female presented with vision of 20/400 OD and 20/20 OS. Vision in her right eye was unchanged and poor since birth. The right nerve was hypoplastic, while the left nerve appeared fairly normal. Learning Points: Hallmarks of optic disc hypoplasia include a decrease in disc diameter, low disc/artery ratio, and the peripapillary… Read More

This 39YO male presented with bilateral floaters and a several-year history of intermittent panuveitis. He had a history of treated hepatitis C. Vision was 20/25 OD and 20/20 OS. Anterior segments were normal. There was mild bilateral vitritis and scattered amelanotic subretinal lesions in each posterior pole. Fluorescein angiography shows staining of these lesions with… Read More

This 47YO male presented with hand motion vision from a macula-off rhegmatogenous retinal detachment (RRD). The outer retinal folds are dramatically imaged in both the Optos color and green channel images. Learning Points: Hydration outer retinal folds are one of the key findings to help differentiate a RRD from exudative and traction retinal detachments. The… Read More

This 25YO female presented with a classic asymptomatic solitary congenital hypertrophy of the RPE (CHRPE). It almost resembles a fist! The borders are well demarcated, with variable coal-black coloration and lacunae of depigmentation. Learning Points: Although CHRPE lesions can enlarge with time (see Shields et al, Ophthalmology 2003;110:1968-1973), they carry virtually no malignant potential. Histologic… Read More

This 51YO male presented with 20/200 vision from an acute central retinal vein occlusion (CRVO). There are virtually no posterior pole hemorrhages. Ultrawidefield Optos fluorescein angiography shows good posterior pole perfusion, although peripheral temporal ischemia is noted. Angiographic cystoid leakage is seen. Triton swept-source OCT confirmed cystoid edema with some subfoveal fluid. Intravitreal anti-VEGF injections… Read More

This 30YO female presented in 2008 with acute severe bilateral vision loss. She had a history of well-controlled type 1 diabetes. There were severe bilateral retinal hemorrhages with white, ischemic maculas. A small preretinal hemorrhage was present just inferior to the right nerve. The right optic nerve was swollen. Disc neovascularization was noted in her… Read More

This 44YO male was referred for an asymptomatic vitreous floater. Upon examination, a large translucent strand was noted posterior to the lens, connecting the posterior capsule of the lens to the optic nerve. Learning Points: The hyaloid vascular system, embryologically located within the hyaloid canal, provides the developing anterior segment with nutrients. The hyaloid artery… Read More

This 71YO female is getting Ozurdex intravitreal injections every 2 months to control her macular edema. Learning Points: The Ozurdex implant slowly releases the steroid and eventually totally absorbs, with the clinical effect usually lasting about 2 to 4 months. The ghost-like remnants can persist for many months (see Kim et al, Retina 2020;40;2226-2231).

This 74YO female has a large complex disciform scar from end-stage age-related macular degeneration (AMD). A very prominent retinal vein drains directly into the substance of the scar inferiorly, indicating a chorioretinal anastomosis. Fluorescein angiography shows diffuse staining of the subretinal scarring. Learning Points: Under normal conditions, the retinal and choroidal circulations remain separate and… Read More

This 49YOM underwent trabeculectomy surgery elsewhere 6 weeks earlier. Peripheral choroidal detachments are noted on Optos imaging. Fluorescein angiography shows significant peripheral ischemia. Recent panretinal photocoagulation was started due to proliferative diabetic retinopathy (neovascularization not visualized due to the choroidals). Learning Points: Choroidal detachment is relatively common after glaucoma surgery. Two mechanisms are believed to… Read More