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This patient was sent in for treatment for possible diabetic macular edema. The retinal thickness map shows central macular thickening. The OCT B-scan shows an adherent, hyperreflective epiretinal membrane (ERM), a faint posterior vitreous detachment overlying the macula, and central cystic-like inner retinal spaces. Muller cells, which extend vertically from the internal limiting membrane to… Read More

This patient has proliferative diabetic retinopathy. The fundus photo shows scattered red and fibrosed neovascularization. The color OCTA image is a composite showing all layers of the retinal vasculature: red is the inner retina, green is the mid-retinal layer, and blue is the outer retina (photoreceptors, which are usually devoid of intrinsic vasculature). The bottom… Read More

This 17YO male presented with sudden unilateral vision loss immediately following a whiplash from a motor vehicle accident. Clinically, he has a yellowish linear subretinal foveal discoloration. OCT shows a focal loss of the outer subfoveal retina. Learning Points: These findings are classic for whiplash maculopathy, in which sudden acceleration/deceleration causes the vitreous to tug… Read More

This patient has a subtle white, opaque retina in the inferior macula due to an acute branch retinal artery occlusion (BRAO). The causative embolus is the tiny white lesion just nasal to the nerve’s center. OCT shows hyperreflectivity from the acutely ischemic inner retinal layers. The black blob on the retinal thickness map reflects an… Read More

This 46YO presented with an asymptomatic vasoproliferative tumor (VPT). The VPT initially appeared as a tongue-like, reddish, elevated, peripheral mass with more posterior subretinal lipid. Fluorescein angiography (FA) revealed the vascular nature of the lesion. He then developed a rhegmatogenous retinal detachment that was repaired with a combined vitrectomy and scleral buckle. The indentation from… Read More

This healthy 40yo female presented with chronic headaches. She was on no systemic medications, and her blood pressure was normal. Her nerves were swollen bilaterally, and a myelinated nerve fiber layer was also noted in her left eye. The retinal nerve fiber layer on OCT was severely thickened bilaterally. Learning Points: The diagnosis of idiopathic… Read More

This patient had an isolated severe macular pucker. The fluorescein angiogram shows a vascular hamartomatous component due to severe retinal vascular distortion and leakage. This vascular component, along with the pigmented appearance of the pucker, helps give the false appearance that this was a combined hamartoma of the RPE. The macular pucker was treated with… Read More

This is a classic case of Coats disease, with unilateral retinal vascular leakage from both the capillary bed and larger vessels. Fundus images show dilated capillaries and retinal vessels. In addition, there are multiple arterial macroaneurysms with surrounding exudate. Fluorescein angiography shows the leaking telangiectatic vessels. Learning Points: Laser photocoagulation can be used to treat… Read More

Our patient had active toxoplasmosis inflammation directly adjacent to the optic nerve and was placed on Bactrim double-strength (DS) and prednisone. The OCT line scans show hyperreflective retinitis with overlying vitreous cells. Learning Points: Toxoplasmosis, the most common cause of infectious chorioretinitis in humans, is caused by the protozoan parasite, Toxoplasma gondii. It is most… Read More

This patient presented with a retinal detachment caused by a giant retinal tear extending from 5 to 11 o’clock. Unfortunately, the retina re-detached since the eye was inadvertently underfilled with perfluorocarbon (PFO) at the time of vitrectomy. The superior edge of the giant tear is open, resulting in a superior detachment. There are numerous small… Read More