Blog

Situs inversus is a congenital abnormality where the retinal vessels exit the optic nerve with a nasal bend prior to heading temporally. Learning Points: Situs inversus occurs in 1 to 2% of the population and is sometimes associated with a tilted optic disc.

This patient was seen initially with inactive peripapillary and macular chorioretinal scarring from serpiginous choroiditis. A year and a half later, he presented with new subfoveal active inflammation. One year later, there was inactive atrophic subfoveal scarring. Learning Points: Serpiginous choroiditis is an idiopathic, usually bilateral chorioretinal inflammatory condition most commonly found in middle-aged men…. Read More

This is a beautiful photograph of an acute sub-internal limiting membrane (ILM) hemorrhage, most commonly found following a Valsalva maneuver or trauma, but can also happen spontaneously, as with anemia. OCT scanning shows marked hyperreflectivity from the sub-ILM blood with posterior shadowing. Learning Points: Sub-ILM hemorrhages virtually always resolve without sequelae, although the blood can… Read More

This 19yo presented with counting fingers (CF) vision OD and 20/20 OS. There is a frosted appearance to the superior retinal veins with surrounding retinal hemorrhages. Fluorescein angiography (FA) shows some vascular staining and optic nerve leakage. The patient was started on oral steroids, and one week later, the fundus findings had improved significantly (not… Read More

This 69YO male has counting-finger vision in his right eye from a fibrotic disciform scar due to wet age-related macular degeneration. Triton swept-source OCT scanning shows hyperreflective subretinal scarring, variable disorganized thinned overlying retinal layers, and outer retinal thickening. Learning Points: This type of end-stage wet AMD was the norm prior to the anti-VEGF era,… Read More

This 65YO presented with 20/400 vision in the left eye. Optos imaging shows classic ocular histoplasmosis (OHS) peripapillary, macular, and peripheral chorioretinal scarring. A more close-up macular image from the Triton swept-source OCT shows a greenish macular neovascularization (MNV) with associated subretinal blood. The OCT B-scan shows subretinal fluid and hyperreflective subretinal blood, which causes… Read More

This 24YO male presented with these fundus findings. Both optic nerves were severely and diffusely swollen with a lipid star in the nasal macula. Blood pressure in the office was 224/145. Learning Points: The nasal macular lipid star originated from the optic nerve, where fluid and lipoproteins leaked into the surrounding tissues. When the fluid… Read More

This 57YO male presented with 20/400 vision in his right eye from a superior macular branch retinal vein occlusion. The OCT at first glance seems to just show superior macular edema extending through the macular center, but why is the superior retinal thickness map black, and what does that mean? The retinal thickness map is… Read More

This 51YO male has heavy bilateral panretinal photocoagulation (PRP) scarring for proliferative diabetic retinopathy (PDR). All laser treatments were done years earlier at an outside practice. The burns are confluent and extend into the arcades. Thankfully, the treating surgeon did not quite burn the optic nerves. However, the visual fields are severely constricted with essentially… Read More

This 60YO male presented with 20/25 vision in his right eye despite a superior uveal malignant melanoma. The tumor was associated with subretinal blood overlying and outside the lesion, as well as a small area of preretinal blood just superior to the optic nerve. Fundus autofluorescence showed no lipofuscin. The tumor measured 5.55mm in thickness,… Read More