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Our patient has relentless placoid chorioretinitis with the multifocal lesions of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and the peripapillary changes of serpiginous choroiditis. This patient demonstrates chorioretinal scars surrounding the optic nerve but also throughout the posterior pole. Additionally, he has recurrent inflammation typical of serpiginous but not APMPPE. His vision is 20/20… Read More

This 88YO female presented with 20/200 vision OD and 20/50 vision OS. Although she complained of nyctalopia since childhood, her vision was good throughout her life up until about a year ago. There was no family history of eye disease. She had bilateral large islands of scalloped chorioretinal atrophy throughout the mid-peripheral fundi, with extension… Read More

This is a picture of a classic solitary congenital hypertrophy of the RPE (CHRPE). The borders are well-demarcated with a variable coal-black coloration. With age, they often develop multiple hypopigmented lacunae that tend to enlarge over time. The CHRPE lesions can also enlarge with time, but carry virtually no malignant potential. Learning Points: Histologic RPE… Read More

This 32YO female presented with 20/400 vision bilaterally, a hemoglobin A1C over 12%, and a blood glucose level over 300. Fibrosed neovascularization variably covers each posterior pole. OCT shows that the posterior hyaloid has spontaneously detached from each central macula, which has a rippled contour. This appearance is also often seen following vitrectomy for tractional… Read More

Our patient had a retinal pigment epithelial (RPE) tear 2 weeks following an injection for wet age-related macular degeneration. The edges of the bare choroid and the edge of the retracted RPE can be visualized. OCT shows bare Bruch’s membrane and the retracted, torn RPE. Learning Points: A tear of the RPE is a fairly… Read More

This 13YO female has unilateral disseminated patches of choroidal melanocytosis, but without anterior segment or skin abnormalities. Learning Points: Choroidal melanocytosis is part of the oculodermal spectrum, which occasionally includes pigmentation of the globe or periocular skin (Nevus of Ota, melanosis oculi). There are increased dendritic melanocytes in the affected tissues following the distribution of… Read More

This patient was shot several times in the head and remarkably survived. He underwent numerous retinal procedures at an outside hospital for a retinal detachment, and currently has light perception (LP) vision. Examination revealed extensive chorioretinal scarring with a mostly detached retina under silicone oil. A large retinal break, possibly from an intraoperative retinectomy, was… Read More

This patient presented with bilateral multiple flame-shaped and white-centered retinal hemorrhages. There is also at least one deeper, round outer plexiform hemorrhage just inferonasal to the nerve. The retinal veins are somewhat dilated and tortuous, consistent with hyperviscosity. This patient was subsequently diagnosed with multiple myeloma. Three years later, the patient was in remission after… Read More

This patient presented with multiple white-centered flame-shaped retinal hemorrhages and sub-ILM hemorrhages consistent with anemic retinopathy. ILM detachment can be seen superior to the hemorrhage anterior to the fovea on the right eye. Learning Points: The term “Roth spot” was named after Dr. Moritz Roth, who, in 1872, noted white-centered hemorrhages in patients with bacterial… Read More

This patient has benign bilateral congenital prepapillary vascular loops. These can be either unilateral or bilateral. Learning Points: Although usually just an incidental finding, they can rarely cause a branch retinal arterial or venous occlusion (see Retinal Cases Brief Rep 2014;8;124-126 and Ophthalmology 2020;127;124-126). They should also not be confused with disc neovascularization, which consists… Read More