Blog

This patient has a vortex vein varix, a benign dilatation that can simulate a choroidal tumor. The diagnosis is clinched when gentle digital pressure on the globe collapses the varix, making it temporarily disappear. Learning Points: The vortex veins provide the major venous outflow for the choroid, subsequently draining into the superior and inferior ophthalmic… Read More

Our asymptomatic patient is being followed yearly for bilateral choroidal colobomas. These patients are at risk for retinal detachment and choroidal neovascularization. Choroidal neovascularization has an increased tendency to develop at the superotemporal edge of the coloboma, which is thought to be caused by the abnormal architecture of the RPE and Bruch’s membrane. Learning Points:… Read More

This 29YO male presented to us 6 years earlier with bilateral cytomegalovirus (CMV) retinal detachments. At that time, he was severely ill from untreated HIV/AIDS. He underwent bilateral vitrectomy surgery with silicone oil. Since then, he has done extremely well systemically, with normal CD4 counts and undetectable viral loads. Despite severe bilateral chorioretinal scarring and… Read More

For many years, we have been following this 55YO male with 20/50 vision and involuted proliferative diabetic retinopathy with a stable extrafoveal traction retinal detachment in his left eye. His right eye was enucleated following several failed vitrectomy surgeries years ago, before he came to our practice. Although completely stable funduscopically, OCT shows some subclinical,… Read More

This healthy 50YO male presented with asymptomatic bilateral peripheral retinal ischemia and temporal neovascularization OD seen on fluorescein angiography. Learning Points: Eale’s disease is an idiopathic peripheral occlusive retinal vasculopathy that can later develop peripheral neovascularization. It is more common in males in their 20’s to 30’s, and may be associated with prior tuberculosis exposure…. Read More

This 81yo presented with peripheral vision loss. Vision was 20/100. She had a large nasal uveal melanoma draping over the optic nerve. The tumor measured 10 mm in thickness and over 23 mm in basal diameter on B-scan ultrasonography. Enucleation was recommended. Learning Points: Clinical characteristics of choroidal nevi at risk for progressing to a… Read More

This is an 80YO female who presented with a branch retinal arterial occlusion (BRAO) and 20/40 vision. The causative calcific embolus is seen overlying the inferior optic nerve. The opaque retina is especially well visualized with the Optos green channel but virtually invisible in the Optos red channel. The vertical B-scan contrasts the normal superior… Read More

The initial photo in this series shows a focal yellow-white nodular lesion with adjacent subretinal blood. The OCT shows subretinal hyperreflective material, some shallow subretinal fluid, and an amelanotic choroidal granuloma. Fluorescein angiography shows staining of the lesion, with some blood blockage along its superior edge. A later fundus photo shows complete resolution of the… Read More

While being followed for peripapillary pachychroid syndrome (PPS) with periodic photodynamic therapy for symptomatic foveal fluid OS, this patient presented with new diffuse pigmentary deposits in the left eye only. Fundus autofluorescence shows a dramatic pattern of hyperautofluorescent and hypofluorescent spots scattered throughout the fundus. These findings, although unilateral, look very similar to those in… Read More

This patient had a small asymptomatic embolus. Elective carotid workup revealed a 95% ipsilateral carotid stenosis that was subsequently treated with carotid endarterectomy. Learning Points: Acute retinal ischemia, defined as transient monocular vision loss (or amaurosis fugax), acute branch retinal artery occlusion, or acute central retinal artery occlusion, requires an immediate referral to the nearest… Read More