Blog

This patient has Best’s disease and has progressed to the more atrophic, ‘scrambled egg’ appearance. The fundus photos show asymmetric layering of the residual yellow-white subretinal vitelliform material. This material is highly autofluorescent and can also appear as hyperreflective on OCT scans. The right eye has a large subfoveal pigment clump with surrounding non-exudative subretinal… Read More

This patient had a known history of treated HIV infection and presented with asymptomatic bilateral irregularly round patches of choroidal and RPE pigmentary loss. Our patient’s findings show what the lesions of pneumocystis choroiditis look like upon resolution. Learning Points: In the early days of the HIV/AIDS epidemic, pneumocystis pneumonia was one of the most… Read More

This patient’s blood vessels appear milky and possibly occluded, although fluorescein angiography is normal. A tube of blood drawn from both the patient and a much younger 25YO future founder of Retina Rocks (in his first year of ophthalmology residency) is displayed for comparison. The patient’s blood shows increased lipid content. Learning Points: Lipemia retinalis… Read More

This 72YO female recently completed a 5-year course of Tamoxifen as adjunctive treatment for breast cancer. She had no visual symptoms with 20/30 vision bilaterally. Clinically, there were subtle bilateral foveal pigmentary changes. B-scan and en-face OCT showed bilateral cavitary changes. Learning Points: Tamoxifen retinopathy shares findings very similar to those of macular telangiectasia type… Read More

This 71YO patient has bilateral, mostly temporal, peripheral deep blot retinal hemorrhages. He had a known history of bilateral carotid stenosis. Our patient’s findings are classic for ocular ischemic syndrome (OIS), with hemorrhages in the deeper retina of the temporal periphery. These patients need to have a carotid Doppler and ultrasound and be referred for… Read More

This previously healthy 36 YO female presented with recent vision loss of 20/200 bilaterally. The right optic nerve is moderately swollen with surrounding mostly deep retinal hemorrhages, faint scattered macular lipid, and a few nerve fiber layer infarcts (cotton wool spots). The left nerve is flat with a few surrounding inner flame-shaped retinal hemorrhages and… Read More

This patient has degenerative retinoschisis with numerous inner-layer holes, best seen on the Optos green channel image. Learning Points: This patient just needs observation due to the small risk of developing a rhegmatogenous detachment. This risk would increase if an outer-layer hole were present, since the inner- and outer-layer holes would essentially represent a full-thickness… Read More

This patient was hammering so hard that a piece of metal was sent flying through his upper lid, into his orbit, bounced off the orbital roof, penetrated his globe from behind in the superior midperiphery, and lodged in the inferior retina. The eye looked completely normal externally since the penetrating injury occurred from behind the… Read More

This patient has optic pit maculopathy, in which areas of subretinal fluid can be traced back to the optic nerve pit via an abnormal communication between the subretinal and subarachnoid spaces. Shed photoreceptor outer segments accumulate on the back surface of the detached retina since the RPE cells can’t perform their normal function of phagocytosis…. Read More

This patient developed hypotony maculopathy one day following vitrectomy for vitreous floaters. Intraocular pressure was 6mmHg and all sclerotomy sites appeared tight. The retinal vessels are somewhat engorged and dilated. Chorioretinal folds are seen in the fundus photo, OCT B-scan and thickness map. These findings completely resolved 9 days later when his IOP recovered spontaneously… Read More