Blog

This asymptomatic patient was found to have a unique bilateral peripapillary chorioretinal atrophy called helicoid peripapillary chorioretinal degeneration. Vision is usually normal, although central vision can rarely be affected if atrophy progresses through the fovea. Learning Points: Helicoid peripapillary chorioretinal degeneration is a benign autosomal dominant condition with degenerative wing or propeller-shaped lesions that radiate… Read More

This 52YO female presented with 20/200 vision in her left eye due to a uveal malignant melanoma. Amazingly, she was completely asymptomatic since she was right eye dominant. The hyperpigmented lesion is well visualized on the Optos red channel and exhibits variable hyper- and hypoautofluorescence. The tumor measured about 5.5mm in thickness and 12mm in… Read More

This 71YO male had a vitrectomy in 2018 for a breakthrough vitreous hemorrhage from ectopic choroidal neovascularization (CNV). He did well with 20/40 vision until a recurrent vitreous hemorrhage developed two years later. The vitreous cleared with several monthly intravitreal Avastin injections, but vision remains at hand motion due to submacular blood, some of which… Read More

This patient with wet age-related macular degeneration (AMD) was being treated with PRN anti-VEGF injections. She came in for her regular examination without new symptoms and with 20/70 vision. Although the OCT line scan shows some fairly subtle new sub-retinal fluid, the color photo dramatically shows new blood. Learning Points: There is currently some debate… Read More

This is a 19YO patient who presented with an asymptomatic retinal break with prominent posterior white without pressure. Learning Points: A retinal break is a full-thickness retinal defect. Breaks are classified as atrophic holes, operculated holes, tractional (horseshoe) tears, and retinal dialysis (break at the ora serrata). In general, asymptomatic retinal breaks are observed since… Read More

This patient presented in 1990 with what we assumed was bilateral inactive colobomatous congenital toxoplasmosis scarring. Learning Points: Choroidal colobomas are most commonly due to failure of the optic vesicle and choroidal fissure to close during fetal development. Multifocal lesions, as seen in our patient, can be caused by congenital toxoplasmosis and Zika. For a… Read More

This 50-year-old male is a 6-diopter hyperope. Optos color, Optos green channel, fluorescein angiography (FA), and OCT reveal prominent chorioretinal folds. Learning Points: Chorioretinal folds appear clinically as often subtle horizontal and oblique subretinal folds. There are extensive intra- and extra-ocular causes for chorioretinal folds. Our patient shows typical findings of idiopathic chorioretinal folds, including… Read More

This 44yo female presented with 20/20 vision and no visual complaints. If you look closely at the color Optos image, you can see a small 1.5 disc diameter subretinal lesion in the superotemporal macula with mild overlying pigmentary changes. The Optos red channel best illuminates the lesion, indicating its choroidal location. Fundus autofluorescence shows very… Read More

This 44YO male presented with classic findings for fundus flavimaculatus, including perifoveal atrophy and variable hyper-autofluorescent subretinal yellow flecks extending from the macula to the midperiphery. Fluorescein angiography (FA) reveals a central dark choroid due to RPE cells becoming engorged with lipofuscin. Surprisingly, vision was 20/20 OU with a negative family history. Learning Points: Fundus… Read More

This 59YO female presented with acute vision loss of 20-100 in her left eye. At first glance, it looks like a macular branch retinal vein occlusion (BRVO) arising from an artery crossing over a vein more proximally. There is a likely macroaneurysm within the area of more confluent inferior macular blood. But a more careful… Read More