Blog

This patient still developed a large foveal subhyaloid hemorrhage despite very full prior panretinal photocoagulation (PRP). Learning Points: PRP has been around since the 1960s and still remains the mainstay for treating proliferative disease. Often considered a “one and done,” patients can still develop break-through hemorrhages. Intravitreal anti-VEGF injections are often helpful, but some will… Read More

This patient had an asymptomatic peripheral lattice-related retinal detachment. Note that the entire lattice lesion represents the flap of the tear, with an adjacent secondary smaller tear. The detachment was demarcated with laser photocoagulation and has remained stable since. Learning Points: Retinal detachment occurs in 1 in 10,000 people per year. Lattice is found in… Read More

This 86YO female has dry AMD and has subretinal drusenoid deposits (SDD) located above the RPE layer. Since they are located above the RPE, they are best visualized with blue or green illumination. Notice how the SDD are easily visible on the Optos green channel but disappear in the red channel. Typical drusen (not pictured)… Read More

Our patient with history of multiple sclerosis (MS) has intermediate uveitis with peripheral vasculitis and overlying clumps of vitreous floaters. These posterior segment findings have been stable for decades and her MS remains in total remission. Learning Points: Although optic neuritis is the most frequent ophthalmic manifestation of multiple sclerosis (MS), patients can also rarely… Read More

This patient’s fundus photo shows a focal yellow-white nodular lesion of the right eye. OCT shows the subretinal hyperreflective material and an underlying choroidal granuloma. Two years later, the patient subsequently developed an active macular neovascularization along the inferior edge of the original lesion, seen better on fluorescein angiography. Learning Points: Choroidal granulomas usually appear… Read More

Examining the fundus with dense asteroid hyalosis, as in this diabetic patient, can be extremely challenging. Fluorescein angiography (FA) and OCT are great modalities since they’re both able to visualize the retina when the clinical exam can’t. FA was critical in diagnosing proliferative retinopathy with peripheral ischemia in this patient. Learning Point: Asteroid hyalosis is… Read More

This patient had prior intravitreal Avastin for macular edema from a hemiretinal vein occlusion (HRVO). When he developed recurrent edema with 20/60 vision, he wanted to try macular laser instead of more injections. Preoperative angiography shows a slightly enlarged foveal avascular zone with diffuse inferior macular leakage. There is some peripheral retinal ischemia but no… Read More

This patient has a melanocytoma, which is a benign melanocytic tumor intrinsic to the optic nerve. They are intensely pigmented with feathery margins, sometimes spreading into the adjacent retina and choroid. Learning Points: Although melanocytomas may enlarge over time, malignant transformation is very rare. Spontaneous necrosis may cause a similar appearance to vitreous seeding from… Read More

Beautiful Optos images of this patient demonstrate extensive bilateral lattice degeneration. Prophylactic laser was placed at an outside institution around some of the lattice lesions in the right eye inferotemporally and around an atrophic hole temporally. There is a pseudo-retinal tear superotemporally in the left eye from a patch of white without pressure. Learning Points:… Read More

This patient, who was in the process of undergoing panretinal photocoagulation for proliferative diabetic retinopathy, was originally seen with NVD and severe nonperfusion. Unfortunately, she was lost to follow-up for 4 months and presented again with increased NVD and new NVE. The Optos fluorscein angiogram shows the complex of fine neovascular vessels and capillary dropout… Read More