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This patient was referred for an asymptomatic, slightly depigmented subretinal lesion in the superior right macula. OCT through this lesion reveals a focal choroidal excavation, choroidal pachyvessels, and probable loculated outer choroidal fluid. Learning Points: Focal choroidal excavation (FCE), originally described by Jampol et al in 2006, is likely part of the pachychoroid spectrum since… Read More

This 80YO female was 20/200 in her right eye due to central macular atrophy from atrophic age-related macular degeneration (AMD). Triton swept-source optical coherence tomography showed outer retinal tubulation (ORT) in the outer retinal layers. The extent of these tubular structures was best visualized on en face imaging. Learning Points: Outer retinal tubulation, initially described… Read More

This 53YO has classic findings of Coats disease. A leaking macroaneurysm in the distal inferotemporal macula is causing exudation with lipid threatening the macular center. Prior macular laser scars are noted in the superior macula. There is a fibrosed macroaneurysm in the temporal midperiphery, and some fibrosed telangiectatic lesions are visible in the superonasal periphery…. Read More

This 25YO female presented with 20/25 vision OU and a four-day history of temporal field loss in her left eye. Examination of the right eye was normal. There was a granular appearance to the left fovea with some deep retinal white dots, most visible just nasal to the nerve. Fundus autofluorescence (FAF) more dramatically showed… Read More

This patient presented in 1994 with classic active cytomegalovirus (CMV) retinitis, which appeared as a “cottage cheese and ketchup” hemorrhagic retinitis following a vascular distribution. The retinitis spreads outwards, leaving behind thinned, necrotic retina and retinal pigment epithelium. Learning Points: CMV retinitis develops as a reactivation of latent CMV in immunosuppressed individuals. Before effective antiretroviral… Read More

This patient with a known history of breast cancer presented with a creamy colored choroidal lesion with central overlying pigmentary changes and scarring in the temporal macula. Fluorescein angiography showed diffuse subretinal leakage with staining of the overlying scar. OCT scanning showed choroidal thickening with an irregular retinal pigment epithelial contour and overlying subretinal fluid…. Read More

This patient presented with a large acute submacular hemorrhage in the right eye. The blood caused diffuse blockage on fluorescein angiography, and the source of the blood may have been from the area of subretinal hyperfluorescence inferiorly. OCT scanning shows a large retinal pigment epithelium (RPE) detachment with notched thumb-like projections with subretinal hyperreflectivity from… Read More

Our patient had bilateral optic nerve colobomas with an optic pit in the left eye. Vision was 20/40 OD and 20/70 OS. The serous fluid from the optic pit is in the superior macula with mild fluid in the subfoveal space, best noted on the macular OCT. Fluorescein angiography shows no leakage, indicating that this… Read More

This 86YO patient was receiving Ozurdex (dexamethasone 0.7%) injections every 8 weeks in her left eye for macular edema from an inferior hemiretinal vein occlusion. She subsequently developed ocular ischemic syndrome (OIS) like changes with scattered peripheral large outer retinal hemorrhages. Inferiorly, more recent Ozurdex implants are noted, along with another ghost-like remnant of an… Read More

This 45YO female presented with 20/40 vision in her left eye with an acute negative scotoma temporal to her visual axis. This corresponded with a focal area of retinal whitening in the nasal macula. This appeared as hyperreflectivity of the inner plexiform, inner nuclear, and outer plexiform layers on OCT and a relative flow void… Read More