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Aug 7 2020 by Rinal Pandit

Ultrasound biomicroscopy image (Transverse scan) of a 30-year-old female with occludable angle. For all young patients presenting with angle closure ,UBM should preferably be performed. It helps establish the cause of narrowing , such as a pseudoplateau configuration in this case produced by multiple CB cysts.

Photographer: Dr Rinal Pandit, Raghudeep eye hospital, Ahmedabad

Imaging device: UBM, ABsolu, Quantel Medical

Condition/keywords: ciliary body cyst

Aug 6 2020 by Kshitij Raizada, MS Ophthalmology

A HIV+ve patient presented to us with bilateral 360 degrees giant retinal tear. The retina in both the eyes lied crumpled on the posterior pole with bare choroid visible all around. 25G pars plana vitrectomy was done in the left eye. On injection of PFCL, the crumpled retina unfolded, just like a bud, blooming into a flower! 360 degrees endolaser was done and PFCL- oil exchange was done without constructing the 4th port.

Condition/keywords: giant retinal tear, HIV, perfluorocarbon fluid

Aug 6 2020 by Patrícia José Figueiredo Lopes

A 49-year-old female with history of insulin-dependent diabetes mellitus, hypertension and hyperlipidemia (managed with HMG-CoA reductase inhibitor plus lipid-lowering compound that inhibits intestinal cholesterol and phytosterol absorption) presented in a routine ophthalmology appointment. On examination, best-corrected visual acuity was 20/20 with an unremarkable anterior segment bilaterally. Funduscopic examination showed no signs of diabetic retinopathy. However, retinal vessels were creamish milky white, only distinguished by their size, suggesting lipemia retinalis (A, right eye; B, left eye). Triglyceride levels were 1500 mg/dL (normal range 0-150 mg/dL). Lipemia retinalis is a rare manifestation of hyperlipidemia but is a valuable tool for the diagnosis and treatment of this disease. The characteristic funduscopic findings include retinal blood vessels discoloration ranging from salmon pink to creamish white, depending on the level of plasma triglycerides. There are few reports about retinal changes in hypertriglyceridemia and all disclose triglyceride concentration exceeding 2,500 mg/dl.

Condition/keywords: hyperlipidemia, lipemia retinalis

Aug 5 2020 by Dhaivat Shah

A 54-year-old healthy male presented to us with a decreased vision in right eye since past 8 years. The patient gave a history of bleed in right eye before 8 years for which some intravitreal injection was given; post which there no major visual improvement. No details or documentation was available regarding the same. His BCVA in the right eye was 5/60. Fundus examination revealed a sharply demarcated hypopigmented patch over the macula with mild posterior excavation suggestive of macular scar. OCT image shows foveal thinning with loss of Retinal pigment epithelium and outer retinal layers (RORA). There are 2 types of RORAs, complete and incomplete. Complete RORA and incomplete RORA are entities defined by various imaging modalities describing atrophy of the retinal pigment epithelial and the outer retinal layers. OCT imaging defines incomplete RORA (iRORA) as a region of signal hyper transmission into the choroid and a corresponding zone of attenuation ordisruption of the RPE (<250um) and evidence of overlying photoreceptor degeneration (<250um). There should not be any RPE tear associated with it. OCT imaging describes complete RORA (cRORA) based on 4 inclusion criteria. These include, area of hypertransmission of more than 250um, zone of attenuation or disruption of the RPE of more than 250um in diameter, evidence of overlying photoreceptor degeneration and absence of scrolled RPE or other signs of an RPE tear. Other modalities used to define these include fundus autoflourescence(FAF), near infrared reflectance(NIR) and color fundus photograph(CFP). On CFP, it shows a sharply demarcated hypopigmented of >250um size with better visibility of choroidal vessels. FAF shows a hypo autoflourescent patch with sharply demarcated borders of size >250um, the colour of which is similar to that of the optic nerve head or retinal blood vessels excluding any pigmentation or artefact. On NIR, it shows a hyperreflective area with sharply demarcated borders of >250um size excluding any artefact. RORA can be seen in conditions like geographical atrophy in ARMD, central areolar choroidal dystrophy, atrophy secondary to anti-VEGF treatment. References: 1. Sadda SR, Guymer R, Holz FG, et al. Consensus Definition for Atrophy Associated with Age-Related Macular Degeneration on OCT: Classification of Atrophy Report 3 [published correction appears in Ophthalmology. 2019 Jan;126(1):177]. Ophthalmology. 2018;125(4):537-548. 2. Guymer RH, Rosenfeld PJ, Curcio CA, et al. Incomplete Retinal Pigment Epithelial and Outer Retinal Atrophy in Age-Related Macular Degeneration: Classification of Atrophy Meeting Report 4. Ophthalmology. 2020;127(3):394-409. 3. Eng VA, Rayess N, Nguyen HV, Leng T. Complete RPE and outer retinal atrophy in patients receiving anti-VEGF treatment for neovascular age-related macular degeneration. PLoS One. 2020;15(5):e0232353.

Photographer: Miss Anjum Zafar Khan

Imaging device: Choithram Netralaya

Condition/keywords: macular scar, outer retina, retinal pigment epithelium

Aug 2 2020 by Kelly Hannan

Iris FA image from a patient with NVI.

Imaging device: Heidelberg Spectralis

Condition/keywords: iris neovascularization

Aug 2 2020 by Kelly Hannan

Myelinated nerve fiber layer.

Imaging device: heidelberg spectralis

Condition/keywords: myelinated nerve fiber layer

Jul 29 2020 by Vinod Kumar

Pars plana cysts found during peripheral indentation at the conclusion of vitrectomy for rhegmatogenous retinal detachment.

Photographer: Vinod Kumar

Imaging device: Still from a video

Condition/keywords: cyst of the pars plana

Jul 29 2020 by Yoshihiro Yonekawa, MD

Fundus photograph of a 10-year-old boy with an incidentally identified torpedo maculopathy.

Photographer: Suely Bascope

Imaging device: Topcon

Condition/keywords: macula lesion, pediatric retina, torpedo maculopathy

Jul 26 2020 by Gareth Lema, MD, PhD

IVFA shows NVE along the inferotemporal arcade with ischemia immediately inferior to the NV.

Condition/keywords: macular hole, proliferative diabetic retinopathy (PDR)

Jul 26 2020 by Gareth Lema, MD, PhD

Full thickness macular hole in the setting of proliferative diabetic retinopathy. An epiretinal membrane is seen along the inferior macula and forms and arc of tangential traction. The patient was asymptomatic and had a distance visual acuity of 20/40.

Condition/keywords: macular hole, proliferative diabetic retinopathy (PDR)

Jul 26 2020 by Gareth Lema, MD, PhD

Full thickness macular hole with traction caused by an epiretinal membrane in proliferative diabetic retinopathy.

Condition/keywords: macular hole, proliferative diabetic retinopathy (PDR)

Jul 25 2020 by SANDEEP KUMAR

PFC in chronic retinal detachment has a vital role. The image is of a 12-year-old girl with open funnel RD. Characteristically PFCLs have high specific gravity ranging from 1.76 to 2.03, low surface tension, and viscosity. These physical properties make perfluorocarbon liquids an ideal for intraoperative tool in vitreoretinal surgery. With high specific gravity they flatten the detcahed retina and push the SRF anteriorly giving surgeon room for maneuvers.

Photographer: Dr Daraius Shroff . Shroff Eye Centre New Delhi

Condition/keywords: perfluorooctane, retinal detachment

Jul 24 2020 by Darin R. Goldman, MD

Widefield fundus photograph of a 56-year-old male patient immediately following intravitreal anti-VEGF injection. Two air bubbles are visible within the mid-vitreous cavity.

Photographer: Alberto Velez, Retina Group of Florida

Imaging device: Zeiss Clarus

Condition/keywords: anti-VEGF, intravitreal, intravitreal injection

Jul 22 2020 by Deepak Bhojwani, MS

Fundus photograph of a 32-year-old male showing large optic disc pit in a colobomatous optic nerve head along with isolated inferior retino-choroidal coloboma. (A rare / coincidental occurrence of multiple congenital anomalies of optic disc and retina)

Photographer: DEEPAK BHOJWANI

Condition/keywords: coloboma of choroid, coloboma of optic disc, congenital optic nerve pit

Jul 21 2020 by William A. Townsend-Pico, MD

Fundus photograph and Fundus autofluoresence of a 21-year-old female with progressive loss of vision OU.

Photographer: Dania Otero, Retina Consultants of Puerto Rico

Imaging device: Optos California Fundus Camera

Condition/keywords: Stargardt's disease

Jul 21 2020 by William A. Townsend-Pico, MD

Fundus photograph and Fundus autofluoresence of a 21-year-old female with progressive loss of vision OU.

Photographer: Dania Otero, Retina Consultants of Puerto Rico

Imaging device: Optos California Fundus Camera

Condition/keywords: Stargardt's disease

Jul 21 2020 by William A. Townsend-Pico, MD

Fundus photograph and Fundus autofluoresence of a 21-year-old female with progressive loss of vision OU.

Photographer: Dania Otero, Retina Consultants of Puerto Rico

Imaging device: Optos California Fundus Camera

Condition/keywords: Stargardt's disease

Jul 21 2020 by William A. Townsend-Pico, MD

Fundus photograph and Fundus autofluoresence of a 21-year-old female with progressive loss of vision OU.

Photographer: Dania Otero, Retina Consultants of Puerto Rico

Imaging device: Optos California Fundus Camera

Condition/keywords: Stargardt's disease

Jul 21 2020 by Patrik Rajs

Combination of Color and FAG image of a patient with a branch retinal vein occlusion after laser treatment.

Photographer: Patrik Rajs, EYE CLINIC of Jan Evangelista Purkyne University and Masaryk Hospital in Usti nad Labem, Czech Republic

Condition/keywords: branch retinal vein occlusion (BRVO)

Jul 19 2020 by Aditya S Kelkar, MS;FRCS;FACS

Fundus photograph of 29-year-old male with both eyes inactive multifocal choroiditis.

Photographer: Dr. Sayali Tidke

Imaging device: CLARUS 500

Condition/keywords: multifocal choroiditis