Blog

This is a 62YO female presented with bilateral vision loss over the past 3 months. Her vision was 20/200 OD and counting fingers OS compared to 20/20 OU at baseline. She was diagnosed with stage 4 ovarian cancer one month earlier. New multifocal, elevated, pigmented choroidal lesions are noted superonasally in the right eye. View… Read More

This 73YOF was referred for persistent bilateral symptomatic pseudophakic cystoid macular edema (CME) despite a course of topical therapy. Vision was 20/70 OU. During the triamcinolone subtenon injection, given through the inferior conjunctival cul-de-sac, the patient complained of severe pain, and the red reflex turned white. We immediately removed the needle. Triamcinolone was dispersed throughout… Read More

This 86YO male presented with symptomatic macular neovascularization (MNV). Color imaging shows nasal patches of subretinal blood and more central subfoveal pigment. OCT scanning shows a hyperreflective MNV above the RPE (type 2 MNV). The peripapillary MNV is seen on OCT angiography. Learning Points: Macular neovascularization is also known by other terms, including choroidal neovascular… Read More

This 79YO male has counting-fingers vision in his left eye, likely due to complications of chronic central serous retinopathy. Optos color imaging shows increased subretinal pigmentation extending around the nerve superiorly and into the macula and inferonasal periphery. Fundus autofluorescence (FAF) more dramatically shows these changes as hypo-FAF. OCT scanning shows diffuse thinning of the… Read More

This is an 86YO female who has stable dry macular scarring from wet age-related macular degeneration with ongoing anti-VEGF injections. Triton swept-source OCT shows numerous outer retinal tubulations (ORT) overlying an inactive type 1 macular neovascularization (MNV). These tubules are more dramatically seen with en face imaging of the outer retina. Learning Points: Outer retinal… Read More

This 50YO male presented for a routine diabetic follow-up. A new asymptomatic peripheral retinal tear causing a rhegmatogenous retinal detachment was noted anterior to full panretinal photocoagulation (PRP) scarring. We will often demarcate asymptomatic retinal detachments with laser photocoagulation (Vrabec and Baumel, Ophthalmology 2000;107:1063-1067). This patient essentially had laser demarcation before his retinal detachment, but… Read More

This 18YO female presented with a 10-day history of pain, redness, and blurred vision in her right eye. Her referring doctor put her on topical prednisolone acetate 1% and ciprofloxacin several days earlier. Vision was 20/60 OD and 20/20 in her normal left eye. There was significant temporal conjunctival injection overlying a deeper scleral nodule… Read More

This patient with involuted proliferative diabetic retinopathy received prior intravitreal Avastin injections for diabetic macular edema. On routine examination, a few asymptomatic silicone oil bubbles were suspended in the superior vitreous. Fluorescein angiography best shows how these bubbles distort and minify the underlying retinal detail. Learning Points: The insulin syringe needles provided by compounding pharmacies… Read More

This 30YO male presented with a one-day history of seeing “dots” in his vision. Vision was 20/25 OD and 20/20 OS. There are multiple deep retinal white dots scattered throughout the posterior pole of each eye. The Optos green channel best shows these white dots compared to the color images. The spots disappear with the… Read More

This 66YO male presented with classic Coats disease findings. Vision was 20/30. Confluent subretinal lipid extends into the peripheral temporal macula. The source for this lipid is noted in the temporal midperiphery, with dilated, irregular telangiectatic vessels with aneurysmal dilations. Learning Points: Laser photocoagulation can be used to treat leaking macroaneurysms and telangiectatic vessels in… Read More