Blog

This asymptomatic patient was found to have a unique bilateral peripapillary chorioretinal atrophy called helicoid peripapillary chorioretinal degeneration. Vision is usually normal although central vision can rarely be affected if atrophy progresses through the fovea. Learning Points: Helicoid peripapillary chorioretinal degeneration is a benign autosomal dominant condition with degenerative wing or propeller-shaped lesions that radiate… Read More

This patient presented with unilateral subretinal and suprachoroidal hemorrhages from a fall 1 month earlier causing blunt facial trauma. Vision was normal and she was asymptomatic. She is being followed without treatment. Learning Points: There will likely be at least one choroidal rupture visible as the overlying blood clears over time. Subretinal blood following blunt… Read More

This patient presented with a total rhegmatogenous retinal detachment in the right eye. The patient underwent repair with pars plana vitrectomy and SF6 gas. The Optos images show a small residual gas bubble at 1-month post-vitrectomy. Two months post-op, the patient’s vision is 20/200. Learning Points: Long-acting intraocular gas is routinely used in vitrectomy for… Read More

Our patient has a very prominent chorioretinal anastomosis from an idiopathic ectopic disciform scar. It is best seen in the Optos color and green-channel images. Learning Points: Under normal conditions the retinal and choroidal circulations remain separate and distinct. Rarely, the two circulations directly connect with each other thru a chorioretinal anastomosis. These can occur… Read More

This patient has gyrate atrophy, a rare autosomal recessive retinal dystrophy characterized by extensive areas of lobular peripheral chorioretinal degeneration that gradually spread posteriorly. Learning Points: Gyrate atrophy is caused by a lack of a vitamin B6-dependent ornithine aminotransferase mitochondrial enzyme, which leads to elevated ornithine levels. Vitamin B6 supplementation and an arginine-restricted diet may… Read More

This patient has a vitreous cyst in the right eye, which can be seen moving around on fluoroscein angiography (FA) as it blocks different areas of the retina. Learning Points: Vitreous cysts are extremely rare, idiopathic asymptomatic and usually diagnosed as an incidental finding as in this patient. If symptomatic, the cyst can be popped… Read More

This patient presented with a giant retinal tear. Against medical advice, the patient adamantly refused vitrectomy on multiple occasions, so we decided to demarcate it with laser photocoagulation. As expected, the detachment progressed through the laser scarring with the development of proliferative vitreoretinopathy. He subsequently needed several vitrectomy procedures, including retinectomy and silicone oil to… Read More

This case demonstrates multiple findings classic for uveal malignant melanoma. Fundus photography show orange pigment (liposfuscin) overlying the hyperpigmented tumor. Fundus autofluorescence (FAF) shows variable hyper- and hypoautofluorescence from the lipofuscin and chronic subretinal fluid from damaged overlying RPE. The OCT shows homogenous thickened choroid from the tumor with variable overlying subretinal fluid. Learning Points:… Read More

The fundus photos demonstrate severe NDPR with cotton wool spots, microaneurysms, and intraretinal hemorrhages. Our patient’s ultra wide-field fundus fluorescein angiography (UW-FFA) shows significant areas of non-perfusion with vascular staining but no neovascularization. Learning Points: In some cases of moderate or severe retinopathy, a baseline fluorescein angiography is performed. UW-FFA can be useful to detect… Read More

Our patient’s optic disc drusen were obvious clinically, on FAF and on OCT. In younger patients they are usually much more difficult to see and can be confused with papilledema. We have found ultrasonography in younger patients cases to be totally unhelpful since drusen don’t calcify until later in life. If fundus autofluorescence (FAF) is… Read More