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This 25YO highly myopic female presented with bilateral encircling areas of snowflake degeneration and lattice degeneration vs a retinal tuft with white without pressure in her right eye. There was no family history of retinal detachment. Learning Points: Snowflake degeneration is a rare, autosomal dominant disorder localized to chromosome 2q36 (Jiao et al, Invest Ophthalmol… Read More

This healthy 30YO female was referred for poor vision in her right eye. She mentioned losing vision in this eye during high school, but couldn’t provide any further details. She also gave a history of hearing loss, which had never been evaluated. Vision was HM OD and 20/30 in her normal left eye. Triton imaging… Read More

This 34YO female presented with 20/20 vision OD and 20/80 vision OS. Optos imaging of her right eye shows inferior fibrotic neovascularization with marked peripheral ischemia, with more extensive fibrovascular proliferation and ischemia in her left eye. The relatively good vision in her left eye is deceiving, with potentially blinding traction lurking just outside the… Read More

This 23YO male initially presented with 5 days of bilateral blurred vision and stabbing pain in his right eye. Vision was 20/400 OU. Panuveitis was noted bilaterally, with moderate granulomatous anterior uveitis, moderate vitreous cells, macular vascular occlusion, and possible vasculitis (not shown). Review of symptoms revealed occasional headache, lack of genital ulcers, but was… Read More

This patient has a unilateral morning glory disc in their left eye with an associated fibrotic disciform scar. OCT scanning shows variable subretinal macular scarring. Learning Points: Morning glory syndrome is typically unilateral and shares some similarities with optic disc coloboma and juxtapapillary staphyloma. This abnormality is named for its striking resemblance to the morning… Read More

This 33YO male has no light perception vision bilaterally following a failed shunt for hydrocephalus when he was 13YO. Both optic nerves are severely pale. There are also bilateral macular pigmentary changes, most likely from resolved secondary macular edema when his nerves were severely swollen before his shunt. Learning Points: Secondary optic nerve atrophy and… Read More

This patient has torpedo maculopathy. This Optomap montage shows how the same lesion appears in color, green laser, and red laser. OCT scanning, not available for this patient, would show attenuation of the RPE and outer retinal layers. Vision is almost always normal. Learning Points: Torpedo maculopathy was originally described by Gass as a solitary… Read More

This 33YO female presented with this symptomatic lesion in her left macula. Vision was 20/25 in her normal right eye and 20/300 in her left eye. A granulomatous lesion is noted in the inferior left macula. A vertical OCT B-scan through this lesion shows choroidal hyporeflective thickening, an overlying subretinal/intraretinal hyperreflective lesion, and superior subretinal… Read More

This patient with a known history of sarcoidosis presented with a swollen optic nerve, vasculitis, and patches of inner retinal opacification. Learning Points: Sarcoidosis, similar to syphilis, has a myriad of ocular presentations, including anterior, intermediate, and posterior uveitis, vasculitis, papillitis, and choroidal granuloma. In our experience, there appears to be little association between active… Read More

This patient with known monoclonal gammopathy presented with bilateral engorged retinal vessels and scattered deep, white-centered retinal hemorrhages. These are most prominent in the temporal periphery. Learning Points: The term “Roth spot” was named after Dr. Moritz Roth, who, in 1872, noted white-centered hemorrhages in patients with bacterial endocarditis. He felt that these white spots… Read More