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This patient has an ischemic branch retinal vein occlusion (BRVO) with extensive collateral vessels. Occlusion occurs when an artery compresses the underlying vein where the vessels share a common adventitial sheath. Extensive collateral vessels cross the temporal horizontal raphe as well as around the occlusion more posteriorly. A small area of disc neovascularization leaks. Learning… Read More

Here we see a patient with the ever-elusive Mike Wazowski Maculopathy (for you Baby Boomers, he stars in Monsters, Inc.). The OCT image, rotated 180 degrees, details a classic Mike Wazowski pattern of edema. In reality, the patient has some non-central diabetic macular edema.

This patient has torpedo maculopathy, originally described by Dr. Gass as a solitary hypopigmented nevus of the RPE. These benign, unilateral lesions are teardrop-shaped and almost always located in the horizontal meridian of the temporal macula. OCT shows attenuation of the RPE and outer retinal layers. Vision is almost always normal. Learning Points These torpedo… Read More

This patient presented with mild bilateral central vision loss (only the right eye is pictured). Typical findings in sex-linked retinoschisis include radiating foveal cystoid macular edema-type changes, which are much more pronounced on red-free imaging. Although classically described as nerve fiber layer schisis (compared to outer plexiform splitting in degenerative schisis), macular OCT here shows… Read More

This 7YO boy presented without visual symptoms and 20/50 vision OD. The left eye was normal. Contracted fibrotic tissue overlying the optic nerve is causing distortion of the surrounding retina, with striae visible through the macula. Some of this fibrosis may also be pigmented nasal to the nerve. This case represents either a combined hamartoma… Read More

This 17YO presented with 20/200 vision OD and diffuse optic disc edema with temporal peripapillary retinitis, peripapillary inner retinal blood, a few areas of focal inner retinitis, and a prominent macular lipid star. The left eye was normal. Our patient tested positive for Bartonella and had a cat (should’ve gotten a dog and opted for… Read More

This patient has angioid streaks that radiate from the optic nerve. These are very easy to miss unless they are explicitly looked for. Optos color and green-channel photographs of the right eye show central macular atrophy with more temporal peaux d’orange changes. The left eye (not pictured) showed identical findings. Fundus autofluorescence (FAF) shows widespread… Read More

This retinal arterial macroaneurysm (RAM) appears as a yellow-white inner retinal lesion along the superotemporal edge of a macular hemorrhage. Angiography confirms the presence of the hyperfluorescent RAM. An OCT line scan through the RAM shows its location in the inner retina. OCT scanning shows that the blood is almost all above the retina and… Read More

Our patient has a bilateral bull’s-eye maculopathy with central foveal sparing. Vision was 20/30 OD and 20/60 OS. Fundus autofluorescence shows central hypo-FAF from loss of the central RPE. The thin surrounding hyper-FAF ring likely represents diseased, at-risk RPE cells. The OCT scans show pericentral outer retinal and RPE loss. Learning Points: Our patient no… Read More

This patient has peripapillary pachychoroid syndrome (PPS), a recently described bilateral condition characterized by nasal macular intraretinal and subretinal fluid. These eyes can look very similar to those of patients with optic pit maculopathy, but without the pit. Additional findings include a thicker nasal macular choroid than temporal macular choroid, choroidal folds (75% of cases),… Read More