Blog

Six weeks prior to this retinal detachment repair, the patient underwent uncomplicated cataract surgery. This image shows TriMoxi (triamcinolone acetonide/moxifloxacin) medication literally “hanging on” the absorbing gas bubble! Learning Points: During cataract extraction, a commonly used combination of triamcinolone (15 mg/mL) and moxifloxacin (1mg/mL) is injected intracamerally. The medication eventually absorbs completely.

This 35 YO male had a severe diabetic tractional retinal detachment with subsequent pars plana vitrectomy a few years prior. Now, macular striae are apparent in the inner retina and are especially dramatic on en face imaging (image 4). Remarkably, this patient maintains 20/40 vision. It is quite common for these postoperative traction detachments to… Read More

This patient has classic findings for Plaquenil (hydroxychloroquine) toxicity, including a bull’s-eye pattern of pericentral RPE and outer retinal atrophy. This is seen clinically as loss of the orange RPE pigment, on OCT as loss of the photoreceptor elements and RPE, and on fluorescein angiography as hyperfluorescent window defects. In the pre-OCT era, patients were… Read More

Our patient shows classic findings for acute Harada’s. The fundus photos and OCT images show bilateral multifocal subretinal exudative detachments with irregular, scattered overlying chorioretinal folds and bilateral optic disc swelling. Fluorescein angiography (FA) shows multifocal subretinal leaks with pooling of fluid below the retina and within outer retinal cystoid spaces, along with leaking “hot”… Read More

Our 54YO patient had a strong family history for macular problems. The fundus photos demonstrate radial cuticular drusen. The OCT scans are even more dramatic with a saw-tooth pattern of drusen. Subretinal hyperreflective material (SHRM) is noted between Bruch’s membrane and the RPE and subretinal fluid is present in the right eye. Learning Points: Dominantly… Read More

This patient is receiving ongoing intravitreal Avastin injections for a type 1 macular neovascularization (MNV) from wet AMD. The injections caused the MNV to involute and contract, dragging the overlying RPE into radiating radial folds. This is best seen in the cool OCT en face view. The RPE folds are also seen in the OCT… Read More

This 22YO white male presented with a large ciliary body uveal malignant melanoma that was about 14mm thick x 18mm in length on B-scan ultrasonography. Unfortunately, the tumor required enucleation since it was too large for radioactive plaque therapy. Learning Points: Large and dilated episcleral (sentinel) vessels are often a tell-tale sign of an underlying… Read More

Our patient was seen recently with asymptomatic macular neovascularization (MNV) associated with a choroidal granuloma. Clinically there was new blood, fluid and lipid. OCT angiography confirms an active MNV. This lesion is deep to the RPE which is consistent with a focal scleral nodule. Learning Points: Choroidal granulomas usually appear as solitary creamy white, round… Read More

This patient had counting fingers vision OD due to a longstanding ischemic CRVO complicated by macular ischemia, disc neovascularization and neovascular glaucoma. Fluorescein angiography shows profound capillary loss throughout the macula along with leaking disc neovascularization. Due to the profound retinal ischemia there is marked OCT thinning of the inner two-thirds of the retina, giving… Read More

Retinal cavernous hemangiomas are usually unilateral, grape-like clusters of aneurysms filled with dark venous blood. A gray membrane often covers its superficial surface. Vision is usually normal and no treatment is required. Rarely vision loss can occur from vitreous hemorrhage. Learning Points: Although most occur sporadically, some may be caused by an autosomal dominant neurocutaneous… Read More