Blog

This 33YO patient presented with a prominent inferior retinal detachment associated with superotemporal retinoschisis with a large outer layer hole (OLH). The OLH was surrounded by laser-like chorioretinal scarring, although the patient denied prior laser surgery. At vitrectomy, a superonasal gutter of peripheral detachment extended to an equatorial tear at 10:30 (not visualized in these… Read More

This 62yo female with a history of type 2 diabetes and mild hearing loss initially presented in 2012 with asymptomatic 20/30 vision OU and bilateral areas of focal macular atrophy and subretinal yellow fleck-like lesions. The retinal pigment epithelial changes were much more pronounced on fluorescein angiography. OCT scanning shows classic wedge defects along the… Read More

This patient presented with an asymptomatic, superotemporal elevation of the retinal vessel, best seen on 3D OCT and red-free fundus photograph. This patient has done well with observation. Learning Points: Originally described by Robertson et al. (Arch Ophthalmology 1971;85:669-672), avulsed retinal vessels result from focal vitreous traction and can cause recurrent vitreous hemorrhage. The traction… Read More

This 46YO female presented with worsening pain and vision loss in her left eye despite being treated two days earlier by the emergency room for conjunctivitis. In our office, vision was counting fingers OS with a granulomatous panuveitis. There is a creamy-white area of confluent retinitis superiorly. The image is hazy due to vitritis. Stat… Read More

This 77YO female initially presented with a vitreous hemorrhage, which obscured her fundus. The blood spontaneously cleared, allowing us to see multiple fibrosed arterial macroaneurysms and subretinal lipid. Fluorescein angiography (FA) shows extensive marked inferotemporal retinal ischemia, scattered capillary dropout, and focal areas of mostly venous staining superiorly and nasally. Panretinal photocoagulation (PRP) was applied… Read More

This 29YO 4-month pregnant female presented with acute vision loss. The internal limiting membrane (ILM) was detached throughout the entire macula, and an inferior-layered sub-ILM hemorrhage spared the macular center. Her hemoglobin was later found to be 11. Learning Points: Acute sub-ILM hemorrhage is most common following a Valsalva maneuver or trauma (which our patient… Read More

This patient presented with superior commotio retinae after being hit in the eye with a bungee cord. The outer retinal opacification was best visualized on the Optos green channel. Vision was 20/30. Fortunately, the retina findings completely resolved 3 weeks later. Learning Points: Commotio retinae follows direct blunt eye trauma. Large areas of peripheral commotio… Read More

This patient initially presented with dramatic pigmented angioid streaks and acute vision loss from macular neovascularization. The classic peau d’orange (orange skin) pigmentary changes are seen in the temporal macula. Seven years later, vision is 20/25 with ongoing anti-VEGF therapy. The angioid streaks are best imaged with the Optos green channel. Learning Points: Macular neovascularization… Read More

This patient has an extremely rare retinal dystrophy called autosomal dominant vitreoretinochoroidopathy (ADVIRC). Its most distinguishing feature is a band of circumscribed chorioretinal atrophy with intraretinal pigment migration extending circumferentially from the equator to the ora serrata. Learning Points: Autosomal dominant vitreoretinochoroidopathy was first described by Kaufman et al (Arch Ophthalmology 1982;100:272-278). It is caused… Read More

This patient’s Optos image demonstrates a large retinal hole and retinal detachment with proliferative vitreoretinopathy (PVR). Learning Points: Proliferative vitreoretinopathy (PVR), consisting of growth of cellular membranes on either retinal surface, develops in about 5-10% of retinal detachments. The membranes contract and foreshorten the retina, likely resulting from an aberrant wound-healing response. There are no… Read More