• Susac's Syndrome

    Feb 13 2018 by John S. King, MD

    Background: 46-year-old WF with CML (stable on Sprycel) saw her PCP for headaches without known cause; Headaches worsened and became confused, disoriented, off balance, and impaired short term memory. Heme-oncology ordered MRI that showed abnormal signal in the cerebellum and other parts of the brain, and LP has elevated protein. LP did show positive tau test, but fortunately, was a false positive for CJD. IV and PO steroids started and symptoms improved. MRI showed much improvement one month since starting steroids. 3 weeks later had a scotoma in right eye and eye doctor did not find anything at that time to cause it. Tinnitus developed (and some intermittent vertigo before that) and ENT referred back to eye doctor, who then referred the patient to Dr. Zocchi. He found a CWS and BRAO superotemporally OD, and bilateral arteritis (see FA). She had some additional work-up for vasculitis. Given the retinal arteritis, cochlear issues, and MRI findings, Dr.Zocchi suspected Susac's Syndrome. She was started on multiple regimens including prednisone, IVIG, azathioprine, and MTX, and has had the best reponse to IVIG. She is stable and doing well with 20/20 vision in both eyes.

    Imaging device: Topcon

    Condition/keywords: Susac's syndrome

  • Susac's Syndrome

    Feb 13 2018 by John S. King, MD

    Background: 46-year-old WF with CML (stable on Sprycel) saw her PCP for headaches without known cause; Headaches worsened and became confused, disoriented, off balance, and impaired short term memory. Heme-oncology ordered MRI that showed abnormal signal in the cerebellum and other parts of the brain, and LP has elevated protein. LP did show positive tau test, but fortunately, was a false positive for CJD. IV and PO steroids started and symptoms improved. MRI showed much improvement one month since starting steroids. 3 weeks later had a scotoma in right eye and eye doctor did not find anything at that time to cause it. Tinnitus developed (and some intermittent vertigo before that) and ENT referred back to eye doctor, who then referred the patient to Dr. Zocchi. He found a CWS and BRAO superotemporally OD (see photo), and bilateral arteritis. She had some additional work-up for vasculitis. Given the retinal arteritis, cochlear issues, and MRI findings, Dr.Zocchi suspected Susac's Syndrome. She was started on multiple regimens including prednisone, IVIG, azathioprine, and MTX, and has had the best reponse to IVIG. She is stable and doing well with 20/20 vision in both eyes.

    Imaging device: Topcon

    Condition/keywords: Susac's syndrome

  • Coats disease

    Feb 12 2018 by Francisco Olguin, MD

    Fundus photograph of an 6-year-old child with leukocoria, FA showed peripheral areas of non-perfusion, telangiectasias and aneurysms.

    Photographer: Francisco Olguin, Asociacion para Evitar la Ceguera en México, APEC. Mexico city.

    Imaging device: RetCam

    Condition/keywords: fluorescein angiogram (FA), leukocoria

  • Coats Disease

    Feb 12 2018 by Francisco Olguin, MD

    Fundus photograph of an 6-year-old child showing telangiectasias and aneurysms, foveal exudation and subtotal exudative retinal detachment.

    Photographer: Francisco Olguin, Asociacion para Evitar la Ceguera en México, APEC.

    Imaging device: Optos

    Condition/keywords: leukocoria

  • Collateral Vessels in Resolved HRVO

    Feb 12 2018 by John S. King, MD

    Initial presentation: 25-year-old AAM; Hx DM, Sarcoidosis, Renal Disease, HTN with recent hypertensive crisis. Collateral vessels likely due to old HRVO with one front of NVE inferiorly; veins attenuated proximal to the collateral vessels.

    Condition/keywords: collaterals, hemicentral retinal vein occlusion, retinal neovascularization

  • Smoke Stack Fluorescein Leakage in Central Serous Chorioretinopathy

    Feb 10 2018 by Mehdi Najafi, MD, PhD

    OCT macula (top left) and fluorescein angiogram of 46-year-old male who presented with sudden onset blurry vision in right eye.

    Imaging device: Optos Ultra Wide-field imaging

    Condition/keywords: central serous chorioretinopathy (CSCR)

  • Macula Sparring Tractional Retinal Detachment

    Feb 9 2018 by Olivia Rainey

    Ultra-wide field pseudocolor image of a 22-year-old male with a macula sparring tractional retinal detachment relating to retinopathy of prematuritiy affecting his right eye.

    Photographer: Olivia Rainey

    Imaging device: Optos

    Condition/keywords: color fundus photograph, demarcation line, macula sparring, Optos, retinopathy of prematurity (ROP), right eye, tractional retinal detachment, ultra-wide field imaging

  • Optic Nerve Head Drusen

    Feb 9 2018 by Olivia Rainey

    Fundus autofluorescence of a 49-year-old female with optic nerve head drusen affecting her left eye. The patient has pseudoxanthoma elasticum with choroidal neovascularization and has been receiving anti-VEGF treatment for many years.

    Photographer: Olivia Rainey

    Imaging device: Heidelberg Spectralis

    Condition/keywords: 30degrees, anti-VEGF, choroidal neovascularization (CNV), fundus autofluorescence (FAF), Heidelburg Spectralis, left eye, optic disc, optic nerve drusen, pseudoxanthoma elasticum (PXE)

  • Peripapillary SRNVM Secondary to Posterior Uveitis

    Feb 9 2018 by Manish Nagpal, MD, FRCS (UK)

    A young lady, 28 years of age complained of decreased vision and presented with a peripapillary srnvm and some lightly pigmented lesions around the fundus suggestive of a episode of posterior uveitis.

    Photographer: Mehul Prajapati

    Condition/keywords: secondary membrane, subretinal neovascularization (SRNV), uveitis

  • Anterior Capsular Opacity

    Feb 8 2018 by Claire Kiernan, MD

    Slit lamp photograph of a 39-year-old female following uncomplicated cataract surgery shown here with dense fibrinous changes of the anterior capsule. This patient underwent Nd:YAG laser anterior capsulotomy with clearing of her visual axis.

    Photographer: Steve Crow, University of Tennessee Hamilton Eye Institute, Memphis, TN

    Condition/keywords: anterior capsule opacification, cataract extraction, cataract surgery

  • Herpetic Keratitis

    Feb 8 2018 by Claire Kiernan, MD

    Slit lamp photograph of a 29-year-old female with herpetic keratitis complicated by deep corneal neovascularization and lipid keratopathy, shown here following Argon laser sectioning and subconjunctival bevacizumab with marked reduction of neovascularization and lipid keratopathy.

    Photographer: Steve Crow, University of Tennessee Hamilton Eye Institute, Memphis, TN

    Condition/keywords: Herpes simplex infection, keratitis

  • Anterior Capsular Contraction Syndrome

    Feb 8 2018 by Claire Kiernan, MD

    Slit lamp photo of a female with underlying Retinitis Pigmentosa Zonulopathy and new anterior capsular contraction syndrome following cataract surgery.

    Photographer: Steve Crow, University of Tennessee Hamilton Eye Institute, Memphis, TN

    Condition/keywords: anterior capsule opacification, cataract surgery, zonules

  • Glaucoma

    Feb 8 2018 by JEFFERSON R SOUSA

    Male patient, 61-years-old in follow-up of glaucoma has several years. She performed trabeculectomy surgery with a tube implant.

    Photographer: JEFFERSON R SOUSA - Study Center and Ophthalmological Research Dr. Andre M V Gomes, Dr. Suel Abujamra Institute São Paulo-Brazil

    Imaging device: Fundus camera Acquisition of the image in the Camera background Topcon TRC-50 Dx - IA, field photo of 50 Degrees. Composition manual adjustment.

    Condition/keywords: glaucoma

  • Retinal Detachment

    Feb 8 2018 by JEFFERSON R SOUSA

    The male patient attended the clinic with low vision. In the retinal and retinal mapping examination, important fudoscopical alterations were observed. Full retinal detachment with Giant rupture in upper temporal arch.

    Photographer: JEFFERSON R SOUSA - Study Center and Ophthalmological Research Dr. Andre M V Gomes, Institute Dr. Suel Abujamra São Paulo-Brazil

    Imaging device: Fundus camera Topcon TRC-50 DX, Imaginet 5.0, campo de 50 graus. Flash 36 / Mosaic with 16 images.

    Condition/keywords: retinal detachment, retinal in rupture

  • Buckle intrusion with Retinal detachment

    Feb 8 2018 by Manish Nagpal, MD, FRCS (UK)

    Patient operated on 10 years back for a scleral buckling surgery presented with decreased vision and had a superonasal retinal detachment along with intrusion of the scleral buckle.

    Photographer: Mehul Prajapati

    Condition/keywords: acute retinal detachment, retinal break, scleral buckle

  • Age-Related-Maculopathy with Advanced Vitreo Macular Traction in Right Eye

    Feb 7 2018 by Ogugua Ndubuisi Okonkwo, MD,FRCS (Edin)

    Right eye Fundus photograph of a 73-year-old woman with age related maculopathy, progressive drusenoid deposits and progressively worsening Vitreomacular Traction (VMT) monitored over a 10 year duration. Requiring surgical release of VMT.

    Photographer: Okonkwo Ogugua, Eye Foundation Retina Institute . Lagos

    Condition/keywords: drusenoid deposit, vitreomacular adhesion, vitreomacular traction (VMT)

  • Age-Related-Maculopathy and Vitreo Macular Adhesion in Left Eye

    Feb 7 2018 by Ogugua Ndubuisi Okonkwo, MD,FRCS (Edin)

    Left eye Fundus photograph of a 73-year-old woman with age related maculopathy , progressive drusenoid deposits and Vitreomacular Adhesion (VMA) monitored over a 10 year duration.

    Photographer: Okonkwo Ogugua, Eye Foundation Retina Institute . Lagos

    Condition/keywords: drusenoid deposit, vitreomacular traction (VMT)

  • Pre-Op-Fern-Like-Appearance-of-VMT

    Feb 7 2018 by Ogugua Ndubuisi Okonkwo, MD,FRCS (Edin)

    Right eye pre operative OCT of a 73-year-old woman with age related maculopathy and progressively worsening Vitreomacular Traction (VMT) , requiring surgical release of VMT. Fern like VMT is seen and undulating RPE layer showing the drusenoid deposits.

    Photographer: Oreoluwa , Eye Foundation Retina Institute . Lagos

    Condition/keywords: drusenoid deposit, vitreomacular traction (VMT)

  • Right Eye One month Post Operative VMT Relaease

    Feb 7 2018 by Ogugua Ndubuisi Okonkwo, MD,FRCS (Edin)

    Right eye one month post-operative OCT showing VMT release with return of the foveal depression and good vision. There is marked reduction in intra retina schisis and preserved outer retina layers.

    Photographer: Oreoluwa, Eye Foundation Retina Institute . Lagos

    Condition/keywords: drusenoid deposit, vitreomacular traction (VMT)

  • PED and VMA-LE

    Feb 7 2018 by Ogugua Ndubuisi Okonkwo, MD,FRCS (Edin)

    Left eye OCT of same 73-year-old female showing drusenoid PED and Vitreomacular Adhesion .

    Photographer: Oreoluwa, Eye Foundation Retina Institute . Lagos

    Condition/keywords: drusenoid deposit, vitreomacular traction (VMT)

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