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This 50YO female with a known history of cutaneous melanoma and renal cell carcinoma presented with a variably pigmented temporal macular lesion. The lesion had an associated shallow serous detachment and overlying lipofuscin, which was hyperautofluorescent. OCT B-scan showed the choroidal mass with overlying hyperreflective lipofuscin. Transpupillary thermotherapy was recommended, but external beam radiation will… Read More

This 80YO male had 20/80 vision in his left eye with ongoing Eylea injections for wet age-related macular degeneration (AMD). Vision was hand motion in his right eye due to an inactive disciform scar. Several months ago, he complained of decreased vision OD and was found to have a dense vitreous hemorrhage. About 6 weeks… Read More

Seventeen months following plaque radiotherapy for a uveal malignant melanoma, this patient developed radiation retinopathy with scattered inner retinal hemorrhages and nerve fiber layer infarcts (cotton wool spots). Vision was counting fingers, although it had been 20/40 ten days following plaque therapy a year and a half earlier. Cystoid macular edema with subretinal fluid is… Read More

This 57YO male gave a history of lifelong poor vision in his left eye. Vision was 20/40 OD and 20/200 OS. A small hyperpigmented foveal scar is noted in his right eye with neurosensory retinal atrophy and irregular elevation of the RPE. A larger, round, variably pigmented, excavated macular scar is noted in his left… Read More

This 25YO male was utilizing a pneumatic hammer without appropriate eye protection when a metal projectile entered his eye and lodged in the superior macula with associated vitreous hemorrhage. He underwent immediate vitrectomy with removal of the foreign body. Learning Points: Siderosis can develop from metallic intraocular foreign bodies (specifically iron) and lead to cataract,… Read More

This 65YO female was taking Elmiron (pentosan polysulphate, PPS) for many years beginning in the mid-1990s. Vision was 20/400 OD and counting fingers OS. Variable yellow-orange atrophic pigmentary changes were noted funduscopically throughout each macula, with more dramatic patches of macular hypoautofluorescence with a peripheral granular hyper- and hypoautofluorescent appearance. OCT scanning showed variable outer… Read More

This 79YO male with a history of chronic open-angle glaucoma (COAG) presented with counting fingers vision from an acute nonischemic central retinal vein occlusion. Even though his COAG was well-controlled with topical therapy, we felt that his glaucoma was a significant risk factor for the occlusion. A fundus photo from before the CRVO shows that… Read More

Multiple temporal retinal tears are visible in this superotemporal macula-on rhegmatogenous retinal detachment. Yet it appears to be held off like Harry Potter’s Dementors. We happen to have a powerful wizard, too. Just look at the beautifully attached retina after a successful pars plana vitrectomy!

This 18YO male has classic findings for X-linked retinoschisis, including vitreous veils and bilateral foveal schisis. The macular schisis involves mostly the inner and outer nuclear layers, while peripherally it involves the nerve fiber layer (not pictured). Vision is 20/400 OD and 20/100 OS. Learning Points: X-linked retinoschisis is caused by a mutation in the… Read More

This patient presented with asymptomatic bilateral retinal venous and arterial vascular tortuosity. There was no significant past medical or family history. Learning Points: This appearance must be differentiated from acquired retinal vascular tortuosity caused by retinal venous occlusive disease, hyperviscosity (polycythemia, dysproteinemia, leukemia etc.), Fabry’s disease, and fetal alcohol syndrome. Familial retinal arteriolar tortuosity, a… Read More