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This 72YO male presented with symptomatic vitreomacular traction (VMT) and 20/40 vision. Various treatment options were discussed, including observation, ocriplasmin (Jetrea), pneumatic vitreolysis, and vitrectomy. He decided to proceed with pneumatic vitreolysis. One week later, OCT showed that the vitreous remained focally attached to the central fovea, with increased traction. Two months following the procedure,… Read More

This 72YO female gave a 30-year history of Plaquenil (hydroxychloroquine) use for lupus. Vision was 20/50 OD and 20/20 OS. There are subtle yet classic findings for Plaquenil toxicity, including a bull’s-eye pattern of pericentral outer retinal atrophy and pigment loss. This is seen clinically as loss of the pericentral orange RPE pigment, on swept-source… Read More

This 57yo female presented with an asymptomatic, unilateral choroidal coloboma inferior to the right optic nerve. Triton swept-source OCT shows a total loss of the RPE and a near-complete absence of the choroid within the coloboma, with marked thinning of the overlying retina. There is also an outpouching of the underlying sclera. Learning Points: Choroidal… Read More

This patient’s fundus shows areas of white without pressure. Typically, there are bilateral peripheral geographic areas of whitish retinal discoloration. Learning Points: White without pressure (WWP) is a common benign peripheral finding, most often seen in darkly pigmented individuals. WWP gets its name because the area appears white without indentation, unlike scleral depression (white with… Read More

This 75 yo retired physician presented with decreased vision and floaters for about 8 weeks. Vision was 20/25 OD and 20/70 OS. Anterior segments were normal except for mild nuclear sclerosis. There are multifocal areas of yellow-white chorioretinal inflammation spreading into the overlying vitreous, along with clumps of inflammatory deposits on the back of each… Read More

This 80YO female presented with a sudden onset of floaters while battling 2 months of persistent iridocyclitis from Herpes zoster ophthalmicus. There was increased anterior uveitis, along with new peripheral temporal retinitis. Despite significant macular ischemia on clinical examination, vision was 20/60. Our patient’s posterior involvement was likely seeded from her anterior segment. Optos fluorescein… Read More

This 78YO male has a history of uveal malignant melanoma (MM), which was successfully treated with initial photodynamic therapy (PDT) (due to the presence of subretinal fluid) followed by transpupillary thermotherapy (TTT) once dry. He developed a secondary branch retinal vein occlusion (BRVO), likely due to thermal damage from the TTT. Vision is 20/30, and… Read More

The 58 yo male with proliferative diabetic retinopathy presented with preretinal blood. Optos fluorescein angiography shows blockage from this blood with scattered areas of midperipheral neovascularization and peripheral ischemia, especially inferonasally. Learning Points: Angiographically, hypofluorescence is classified as either a blockage or a filling defect. Blood, which masks the underlying retinal and choroidal fluorescence, causes… Read More

This 55YO male presented with macular telangiectasia type 2 (MacTel2). He was visually asymptomatic, and vision was 20/40 OD and 20/50 OS. This case highlights various multimodal imaging findings. The foveal retina shows a whitish discoloration, most likely due to retinal opacification resulting from Müller cell dysfunction. There are variable macular hyper- and hypofAF abnormalities,… Read More

For over 20 years, we’ve been following this 39YO male with stable regressed retinopathy of prematurity in his left eye. Vision is NLP OD and 20/80 OS. Optos imaging shows that the macular center is dragged temporally due to vitreoretinal traction from regressed neovascularization. The macular center is usually about 2 disc diameters temporal to… Read More