Blog

This patient presented with bilateral inner-retinal flame-shaped hemorrhages and nerve fiber layer infarcts. There was no past ocular or past medical history. In the office, her blood sugar was normal but her blood pressure was 160/92. In this patient’s OCT, the macular fluid is coming mostly from the nerves; note the early nasal macular star… Read More

Our patient shows classic bilateral findings for macular telangiecasia (MacTel) type 2 with coarse pigment clumps. The OCTs show central/temporal retinal atrophy with disorganized retinal layers. Absent in our patient, the OCT will also often display hyporeflective cavitations of tissue loss. The majority of patients will also have subclinical chorioretinal anastomosis in association with right-angle… Read More

This patient was hit in the eye with a soccer ball and developed outer retinal whitening due to shearing of the outer segments. OCT reveals subfoveal ellipsoid zone (EZ) disruption and hyperreflectivity. The retinal whitening usually disappears within a few weeks due to regeneration of the photoreceptors Learning Points: Commotio retinae follows direct blunt eye… Read More

This patient with pseudoxanthoma elasticum (PXE) has classic extensive angioid streaks with peaux d’orange (orange skin). The orange skin appearance is caused by the calcified Bruch’s membrane giving a yellow mottled appearance that contrasts with the normal orange RPE and choroidal pigmentation. The green channel (532 nm) Optos images best show these findings in the… Read More

This 62YOM presented with vision loss from waxing and waning shifting unilateral subretinal fluid with marked chorioretinal folds and thickened choroid on OCT. We initially agreed with the likely diagnosis of posterior scleritis that was suggested by a retinal specialist out of state. However, fluorescein angiography showed no leakage and he failed to improve with… Read More

The patient was initially diagnosed with idiopathic cystoid macular edema (CME) and a small foveal detachment with vitreomacular adhesion (VMA). Vision was 20/50. Although the vitreous was attached centrally, a foveal depression remained which would be unusual if vitreomacular traction (VMT) were the cause. The patient was observed without treatment, and 3 months later vision… Read More

This patient, courtesy of Southern College of Optometry, presented with a large temporal peripheral area of active neovascularization from proliferative sickle cell retinopathy in the right eye. The left fundus was normal. Learning Points: Patients with sickle cell disease develop symptoms throughout their body from stiffened sickled red blood cells blocking capillary beds. In the… Read More

An automobile manufacturing worker from our local Ford plant presented with an acute injury to his left eye while installing a catalytic converter. A large metallic intraocular foreign body (IOFB) shot through the pars plana in a self-sealing wound and lodged in the posterior vitreous without any direct retinal injury. Since the material was made… Read More

This patient has a history of retinopathy of prematurity (ROP) with severe but stable traction with retinal folds extending from the optic nerve into the inferotemporal periphery. The diffuse chorioretinal scarring is due to chronic retinal traction. Learning Points: These types of outcomes can be minimized with aggressive neonatal screening and treatment with laser photocoagulation… Read More

This patient had an uncomplicated Ahmed tube surgery 2 weeks prior, but he did not stop his IOP-lowering medication nor take his prescribed anti-inflammatories and atropine. His IOP was 4 mmHg, which led to choroidal detachments. The subretinal blood noted superotemporally is likely iatrogenic from an inadvertent overly deep suture used to secure the Ahmed… Read More