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This 60YO female presented with 20/70 vision OD and 20/50 vision OS, along with classic findings of macular telangiectasia type 2 (MacTel2). The perifoveal retina is somewhat opaque with significant pigmentary changes, particularly in the right eye. OCT scanning of the right eye shows significant central outer retinal atrophy with hyper-reflective pigment migration. The left… Read More

This 74YO female presented with a 2-week history of progressive vision loss in her right eye. Vision was 20/200 OD and 20/20 OS. Optos imaging shows a large, creamy-colored temporal choroidal lesion extending into the right temporal macula. The fovea is markedly elevated and tilted along the nasal edge of the tumor. Two smaller and… Read More

A healthy 32YO female presented with a 6-month history of vision loss in her right eye. Vision was counting fingers OD and 20/20 in her healthy left eye. Fundus imaging shows a slightly elevated, creamy white, subfoveal lesion surrounded by slightly hyperpigmented macular scarring. OCT shows a hyperreflective subretinal lesion that shadows the underlying choroid…. Read More

This 49YO female presented with a 1-month history of bilateral vision loss and eye pain. Vision was 20/200 OU. There was a mild-moderate, bilateral nongranulomatous anterior uveitis. Vitreous debris was centered over each posterior pole, which was grossly normal. Fundus autofluorescence (FAF) shows an oval region of placoid hyper-FAF in each posterior pole. Fluorescein angiography… Read More

A 44YO female with type 2 diabetes presented on 4/25/22 with a 2-week history of severe vision loss in her left eye. Vision was counting fingers OS. Ocular examinations were normal except for a markedly swollen left optic nerve. There were very faint, scattered, hard exudates. OCT showed an average nerve fiber layer thickness of… Read More

A 67YO female was referred for asymptomatic retinal findings in her right eye. She gave a history of unspecified head trauma as a child. Optos imaging shows chorioretinal scarring with intraretinal pigment migration, extending superotemporally and inferotemporally from the optic nerve. The left fundus was completely normal. Learning Points: Photoreceptor loss from numerous causes, including… Read More

This healthy 51YO female presented with one year of increasing flashes in her right eye. Vision was 20/25. Funduscopic examination revealed a large, variably pigmented nasal choroidal mass measuring at least 9.7mm in the largest basal diameter. She was referred for further evaluation and treatment for a presumed uveal malignant melanoma.

This 29YO male with type 1 diabetes presented with severe peripheral proliferative diabetic retinopathy (PDR). Despite having extensive peripheral ischemia and neovascularization, the posterior poles were remarkably almost normal. Learning Points: These types of presentations are very humbling for us clinicians and remind us of the importance of peripheral retinal examination and ultra-widefield imaging with… Read More

This 80YO female with a known history of dry AMD presented with a 3-week history of poor vision in her left eye. Vision was hand motion from a dense vitreous hemorrhage. B-scan ultrasonography showed a thickened temporal subretinal lesion without retinal detachment (not shown). One day following vitrectomy, vision improved to 20/100. The temporal subretinal… Read More

This 64YO male received prior photodynamic therapy in one of his eyes for idiopathic central serous chorioretinopathy (ICCS) and was subsequently lost to follow-up for 10-15 years. He presented with 20/400 vision bilaterally. Multimodal imaging shows classic findings for chronic ICSC. Optos color imaging shows macular and peripapillary pigmentary changes with a suggestion of an… Read More