Blog

This 51YO female with type 2 diabetes presented with severe peripheral proliferative diabetic retinopathy (PDR). Despite having extensive angiographic neovascularization encircling each posterior pole, these findings are remarkably less obvious on color imaging. Learning Points: These types of presentations are very humbling to us clinicians and remind us of the importance of peripheral retinal examination… Read More

This 28YO female presented with bilateral symmetric creamy colored blood vessels (only left eye shown). Triglycerides were markedly elevated above 1000. The vascular appearance normalized 4 months following systemic treatment with a relatively normal triglyceride level of 189. Learning Points: Lipemia retinalis is a rare retinal manifestation of severe hypertriglyceridemia, characterized by creamy white discoloration… Read More

This 59YO male presented with sudden flashes and large floaters in his right eye. Optos imaging shows a small, superotemporal causative retinal tear. There is a moderate central vitreous hemorrhage, a layered inferior pre-retinal hemorrhage, and more inferior blood collecting along the attachment of the vitreous base. The vitreous has multiple attachments, the strongest of which is… Read More

This 74YO female was receiving periocular and intravitreal steroids for persistent pseudophakic cystoid macular edema (CME). Steroid response prevented further treatment, and she eventually required XenGel glaucoma surgery to control her pressure and allow for continued CME treatment. Four days following glaucoma surgery, vision was 20/200, and the intraocular pressure (IOP) was 6 mmHg. Optos… Read More

This 57YO female presented with 2 weeks of blurred vision. There was a 10-year history of type 2 diabetes and prior use of intravenous crack cocaine, though she claimed to have been clean for 18 years. Vision was 20/30 OD and 20/60 OS. The intraocular pressures were normal, but diffuse rubeosis was seen in her… Read More

This 64YO female presented with one month of symptomatic vitreous floaters and 20/70 vision in her left eye. Clinical examination and Optos photography with fluorescein angiography (not shown) confirmed an inferotemporal ischemic branch retinal vein occlusion (BRVO) with severe ischemia and scattered areas of retinal neovascularization. She was scheduled to return for scatter laser photocoagulation,… Read More

This 77YO man presented counting fingers vision OS with what seems at first to be an uneventful fibrotic disciform scar from neovascular AMD. But multimodal imaging shows several interesting findings. Swept-source OCT through the macular center shows that the central scar extends through the full-thickness retina and becomes incorporated with the attached vitreous. A 3D… Read More

This 59YO male presented with vision of 20/400 OD and 20/30 OS. He has severe lifelong hearing loss, and both he and his mother have type 2 diabetes. Optos ultrawidefield imaging shows temporal macular atrophy. Fundus autofluorescence shows the true extent of the pathology, with linear interconnected subretinal streaks of hyper-FAF associated with areas of… Read More

This 65YO female is receiving ongoing anti-VEGF therapy in her right eye for macular neovascularization (MNV). Optos imaging shows an inactive pigmented MNV OD and bilateral peripapillary degenerative propeller-shaped lesions radiating from the optic nerves. Vision is 20/40 OD and 20/30 OS. Learning Points: Helicoid peripapillary chorioretinal degeneration (HPCD) is a benign autosomal dominant disorder… Read More

This 65YO female presented with dramatic bilateral optic nerve drusen with severe visual field defects. Vision was 20/20 OU. Learning Points: Optic disc drusen are refractile calcific concretions that form anterior to the lamina cribrosa. They are felt to be extruded extracellular calcified mitochondria and may be inherited as an autosomal dominant trait. Most patients… Read More