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This 71YO female was treated elsewhere with barrier laser around degenerative schisis in her right eye. Over the past 9 months, the inferotemporal schisis cavity has gradually enlarged. The yellow line indicates the original location of schisis. At the most recent visit on 10/6/21, the schisis cavity extended through the barrier laser. Triton swept-source OCT… Read More

This 41YO female presented with acute unilateral vision loss in her right eye. Vision was 20/50 OD and 20/20 OS. The exam revealed unilateral radiating deep Henle layer retinal hemorrhages with no identifiable systemic or ocular etiologies. Learning Points: Named by Kon Graversen et al (Retina 2014;34:483-489), hemorrhagic unilateral retinopathy presents with unilateral, deep intraretinal… Read More

This 61YO male patient presented with a non-ischemic central retinal vein occlusion (CRVO), 20/30 vision, and macular edema. With ongoing Eylea treat-extend protocol, the hemorrhages and macular edema completely resolved. Prominent optic nerve collaterals were noted. Learning Points: Before the introduction of intravitreal injections in the early 2000s, there were essentially no treatments for CRVO-related… Read More

This 40YO female reported a 7-year history of reading difficulties and glare while driving at night. Optos imaging shows severe diffuse chorioretinal scarring with intraretinal pigment migration extending from the optic nerves to the retinal peripheries. The lobular nature of the chorioretinal changes is best seen with fundus autofluorescence. There was variable bilateral choroidal and… Read More

This 74YO female had a long history of Elmiron (pentosan polysulfate, PPS) use. Vision was 20/30 OU. Variable yellow-orange atrophic pigmentary changes were noted throughout each macula, with more dramatic patches of macular and peripapillary hyper- and hypoautofluorescence. Triton swept-source OCT showed some patchy ellipsoid loss OD and diffuse hyperreflectivity of the outer segments. Learning… Read More

This 34YO female, a local optometrist’s sister, was referred for these asymptomatic bilateral macular changes consistent with a macular dystrophy. Fundus images show symmetrical yellowish subretinal pigmented drusen-like changes. Fundus autofluorescence reveals that these lesions are variably hyper- and hypoautofluorescent. OCT scans show some variable ellipsoid zone loss and outer retinal atrophy, as well as… Read More

This 55YO male presented with 20/50 vision OD and 20/100 vision OS. Optos color imaging shows bilateral areas of relatively confluent patchy macular atrophy. The RPE changes are much more pronounced on fundus autofluorescence. OCT scanning shows outer retinal and RPE loss within the areas of clinical atrophy. Learning Points: Maternally inherited diabetes and deafness… Read More

This 56YO male presented with two weeks of bilateral fuzzy vision. He gave a history of well-controlled hypertension and type 2 diabetes. Vision was 20/30 OD and 20/25 OS. Both optic nerves are swollen, and there are scattered intraretinal hemorrhages.  Blood pressure was 210/130. He was immediately sent to the nearest emergency room. Learning Points:… Read More

This patient has a melanocytoma, which is a benign melanocytic tumor intrinsic to the optic nerve. They are intensely pigmented with feathery margins, sometimes spreading into the adjacent retina and choroid. Learning Points: Although they may enlarge over time, malignant transformation is very rare. Spontaneous necrosis may present with a similar appearance to vitreous seeding… Read More

This 59YO male with a history of type 2 diabetes presented with bilateral diabetic macular edema. Vision was counting fingers OD and 20/30 OS. There was extensive bilateral macular lipid, particularly in his right eye. Venous beading and sausaging were noted OD, indicating severe retinal ischemia. Fluorescein angiography confirmed severe ischemia with peripheral temporal retinal… Read More