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This patient has a full thickness macular hole without traction. The en face image offers a unique perspective on an otherwise unremarkable case. Learning Points: The radiating cysts, as described in Govetto et al AJO 2020;212;43-56, have a sunflower appearance showing features of both exudative and tractional cystoid spaces. The macular hole should be hyporeflective… Read More

This patient was treated as a child for retinoblastoma, although unfortunately we don’t know the details of her prior treatment. She has a calcified, elevated peripapillary lesion with overlying vitreous seeds. There is also a scar in the inferonasal midperiphery from another destroyed tumor. The multifocal nature of her tumors indicates that this was a… Read More

This 16YO presented with a chronic inferior macula-off rhegmatogenous retinal detachment (RRD). Vision was 20/200. What’s most unique about this detachment is the rare appearance of intraretinal macrocysts inferonasally. These cysts are a sign of very long-standing retinal detachments. The multiple demarcation lines also indicate chronicity. Learning Points: During RRD repair, the cysts require no… Read More

This patient has bilateral 20/400 vision due to classic findings from Stargardt disease, including yellow subretinal flecks and outer retinal/RPE atrophy. FAF primarily displays hyperfluorescence from RPE lipofuscin. Since Stargardt is essentially a lipofuscin storage disease, the subretinal flecks are hyperautofluorescent and the areas of RPE loss are hypoautofluorescent. Learning Points: Stargardt disease is an… Read More

This 39YO presented with severe PDR in both eyes, highlighting nearly all of the key features of proliferative disease. Surprisingly, vision was 20/30 OD and 20/50 OS. The right eye shows great examples of venous loops and venous beading and extensive scattered NVE, especially highlighted by the green channel Optos. The left eye has a… Read More

This patient has an epiretinal membrane with some vitreomacular traction. This case was submitted by Dr. Jennifer Reynolds. The “artistic” mind of the submitting doctor, noticed the hand of the Creator in this scan!

This patient presented with acute vision loss from a fresh central retinal artery occlusion (CRAO). Of note, this patient also has involuted PDR following full PRP. The cherry red spot is caused by the unaffected foveal retina (receiving intact choroidal blood flow) being surrounded by more distal white and ischemic retina no longer receiving circulation… Read More

The large submacular hemorrhage is likely from a macular neovascularization from polypoidal choroidal vasculopathy. The patient was treated with vitrectomy, subretinal tissue plasminogen activator (TPA), and fluid air exchange. The TPA helped liquefy the clot, which was then hydraulically displaced inferiorly outside the macula by the gas bubble. At six months post-op, the central macula… Read More

This patient presented with bilateral diabetic traction detachments with counting fingers OD and 20/400 OS. The fibrotic neovascularization is particularly severe in his right eye, obscuring the entire posterior pole. He subsequently underwent bilateral pars plana vitrectomy. An image of the left eye is shown about 9 months later. All neovascular tissue was removed intraoperatively… Read More

Our patient (courtesy of Tufts) has the classic mulberry appearance of a retinal astrocytic hamartoma. Early in life the inner retinal lesions have a fleshy white appearance and are often multifocal and bilateral. Later in life they develop the mulberry or fish egg-like appearance with significant calcification. Fluorescein angiography (FA) shows the often angiomatous nature… Read More