Hosam Attia, MD » Unilateral Acute Idiopathic Maculopathy (UAIM)

Jul 24 2018 by Hosam Attia, MD

20-year-old white, male presented for initial evaluation with one week history of acute, sudden, painless loss of central vision in his right eye a week prior to presentation. - H/O short course of exogenous testosterone, Tamoxifen and Clomiphene intake ~ 2-3 weeks cycle, which was already stopped, prior to development of pt's symptoms. - H/O acute illness with generalized fatigue, malaise, URTI like symptoms and rash over the hands and chest, just prior to symptoms development, and upon further discussion, patient mentioned that few of his friends got sick around the same time. - Patient was seen the week prior by general ophthalmologist and was found to have SRF on OCT , diagnosed with CSCR and referred for retina evaluation. - ROS/ PMHx: negative, healthy aside from the short illness described above - Denied any prior vision problems, similar episodes, trauma etc - VA Dsc OD: 20/400 OS:20/20 - anterior segment exam - unremarkable - posterior segment - macular RPE changes/ clumping with GA with no CME/ SRF or crystals OD, and unremarkable OS. - pseudocolor and FAF photos: RPE changes/ clumps with GA and stippled autofluorescense OD, unremarkable OS. - HD SD-OCT: thickened choroid, thickened/ hypertrophied subfoveal RPE with hyper-reflective material on the apical side of the retinal pigment epithelium/apical debris, subfoveal ellipsoid zone atrophy with intact ELM with no CME or SRF OD, unremarkable OS. - FA: Dye not available - ICG: deferred - mf-ERG and VF - patient rescheduled

Imaging device: Optos - California

Condition/keywords: unilateral acute idiopathic maculopathy

Jul 24 2018 by Hosam Attia, MD

20-year-old white, male presented for initial evaluation with one week history of acute, sudden, painless loss of central vision in his right eye a week prior to presentation. - H/O short course of exogenous testosterone, Tamoxifen and Clomiphene intake ~ 2-3 weeks cycle, which was already stopped, prior to development of pt's symptoms. - H/O acute illness with generalized fatigue, malaise, URTI like symptoms and rash over the hands and chest, just prior to symptoms development, and upon further discussion, pt mentioned that few of his friends got sick around the same time. - Patient was seen the week prior by general ophthalmologist and was found to have SRF on OCT , diagnosed with CSCR and referred for retina evaluation. - ROS/ PMHx: Negative, healthy aside from the short illness described above - Denied any prior vision problems, similar episodes, trauma etc - VA Dsc OD: 20/400 OS:20/20 - anterior segment exam - unremarkable - posterior segment - macular RPE changes/ clumping with GA with no CME/ SRF or crystals OD, and unremarkable OS. - Pseudocolor and FAF photos: RPE changes/ clumps w/ GA and stippled autofluorescense OD, unremarkable OS. - HD SD-OCT: thickened choroid, thickened/ hypertrophied subfoveal RPE with hyper-reflective material on the apical side of the retinal pigment epithelium/apical debris, Subfoveal ellipsoid zone atrophy w/ intact ELM W/No CME or SRF OD, Unremarkable OS. - FA: Dye not available - ICG: deferred - mf-ERG & VF - patient rescheduled

Imaging device: Optos - California

Condition/keywords: unilateral acute idiopathic maculopathy

Jul 24 2018 by Hosam Attia, MD

20-year-old white, male presented for initial evaluation with one week history of acute, sudden, painless loss of central vision in his right eye a week prior to presentation. - H/O short course of exogenous testosterone, Tamoxifen and Clomiphene intake ~ 2-3 weeks cycle, which was already stopped, prior to development of patient's symptoms. - H/O acute illness with generalized fatigue, malaise, URTI like symptoms and rash over the hands and chest, just prior to symptoms development, and upon further discussion, pt mentioned that few of his friends got sick around the same time. - Patient was seen the week prior by general ophthalmologist and was found to have SRF on OCT , diagnosed w/ CSCR and referred for retina evaluation. - ROS/ PMHx: Negative, healthy aside from the short illness described above - Denied any prior vision problems, similar episodes, trauma etc - VA Dsc OD: 20/400 OS:20/20 - anterior segment exam - unremarkable - posterior segment - macular RPE changes/ clumping with GA with no CME/ SRF or crystals OD, and unremarkable OS. - Pseudocolor & FAF photos: RPE changes/ clumps with GA and stippled autofluorescense OD, Unremarkable OS. - HD SD-OCT: thickened choroid, thickened/ hypertrophied subfoveal RPE with hyper-reflective material on the apical side of the retinal pigment epithelium/apical debris, subfoveal ellipsoid zone atrophy with intact ELM with no CME or SRF OD, unremarkable OS. - FA: Dye not available - ICG: deferred - mf-ERG & VF - pt rescheduled!

Imaging device: Optos - California

Condition/keywords: unilateral acute idiopathic maculopathy

Jul 24 2018 by Hosam Attia, MD

20-year-old white, male presented for initial evaluation with one week history of acute, sudden, painless loss of central vision in his right eye a week prior to presentation. - H/O short course of exogenous testosterone, Tamoxifen and Clomiphene intake ~ 2-3 weeks cycle, which was already stopped, prior to development of pateint's symptoms. - H/O acute illness with generalized fatigue, malaise, URTI like symptoms and rash over the hands and chest, just prior to symptoms development, and upon further discussion, patient mentioned that few of his friends got sick around the same time. - Patient was seen the week prior by general ophthalmologist and was found to have SRF on OCT, diagnosed with CSCR and referred for retina evaluation. - ROS/ PMHx: negative, healthy aside from the short illness described above - Denied any prior vision problems, similar episodes, trauma etc - VA Dsc OD: 20/400 OS:20/20 - anterior segment exam - unremarkable - posterior segment - macular RPE changes/ clumping with GA with no CME/ SRF or crystals OD, and unremarkable OS. - pseudocolor and FAF photos: RPE changes/ clumps with GA & stippled autofluorescence OD, unremarkable OS. - HD SD-OCT: thickened choroid, thickened/ hypertrophied subfoveal RPE with hyper-reflective material on the apical side of the retinal pigment epithelium/apical debris, subfoveal ellipsoid zone atrophy with intact ELM with no CME or SRF OD, unremarkable OS. - FA: Dye not available - ICG: deferred - mf-ERG & VF - patient rescheduled

Imaging device: Optos - California

Condition/keywords: unilateral acute idiopathic maculopathy

Jul 24 2018 by Hosam Attia, MD

20-year-old white, male presented for initial evaluation with one week history of acute, sudden, painless loss of central vision in his right eye a week prior to presentation. - H/O short course of exogenous testosterone, Tamoxifen and Clomiphene intake ~ 2-3 weeks cycle, which was already stopped, prior to development of pt's symptoms. - H/O acute illness with generalized fatigue, malaise, URTI like symptoms and rash over the hands and chest, just prior to symptoms development, and upon further discussion, pt mentioned that few of his friends got sick around the same time. - Patient was seen the week prior by general ophthalmologist and was found to have SRF on OCT , diagnosed with CSCR and referred for retina evaluation. - ROS/ PMHx: Negative, healthy aside from the short illness described above - Denied any prior vision problems, similar episodes, trauma etc - VA Dsc OD: 20/400 OS:20/20 - anterior segment exam - unremarkable - posterior segment - macular RPE changes/ clumping with GA with no CME/ SRF or crystals OD, and unremarkable OS. - Pseudocolor and FAF photos: RPE changes/ clumps w/ GA and stippled autofluorescense OD, unremarkable OS. - HD SD-OCT: thickened choroid, thickened/ hypertrophied subfoveal RPE with hyper-reflective material on the apical side of the retinal pigment epithelium/apical debris, Subfoveal ellipsoid zone atrophy w/ intact ELM W/No CME or SRF OD, Unremarkable OS. - FA: Dye not available - ICG: deferred - mf-ERG & VF - patient rescheduled

Imaging device: Zeiss-Cirrus 4000

Condition/keywords: unilateral acute idiopathic maculopathy

Jul 24 2018 by Hosam Attia, MD

20-year-old white, male presented for initial evaluation with one week history of acute, sudden, painless loss of central vision in his right eye a week prior to presentation. - H/O short course of exogenous testosterone, Tamoxifen and Clomiphene intake ~ 2-3 weeks cycle, which was already stopped, prior to development of pt's symptoms. - H/O acute illness with generalized fatigue, malaise, URTI like symptoms and rash over the hands and chest, just prior to symptoms development, and upon further discussion, pt mentioned that few of his friends got sick around the same time. - Patient was seen the week prior by general ophthalmologist and was found to have SRF on OCT , diagnosed with CSCR and referred for retina evaluation. - ROS/ PMHx: Negative, healthy aside from the short illness described above - Denied any prior vision problems, similar episodes, trauma etc - VA Dsc OD: 20/400 OS:20/20 - anterior segment exam - unremarkable - posterior segment - macular RPE changes/ clumping with GA with no CME/ SRF or crystals OD, and unremarkable OS. - Pseudocolor and FAF photos: RPE changes/ clumps w/ GA and stippled autofluorescense OD, unremarkable OS. - HD SD-OCT: thickened choroid, thickened/ hypertrophied subfoveal RPE with hyper-reflective material on the apical side of the retinal pigment epithelium/apical debris, Subfoveal ellipsoid zone atrophy w/ intact ELM W/No CME or SRF OD, Unremarkable OS. - FA: Dye not available - ICG: deferred - mf-ERG & VF - patient rescheduled

Imaging device: Zeiss-Cirrus 4000

Condition/keywords: unilateral acute idiopathic maculopathy

Jul 24 2018 by Hosam Attia, MD

20-year-old white, male presented for initial evaluation with one week history of acute, sudden, painless loss of central vision in his right eye a week prior to presentation. - H/O short course of exogenous testosterone, Tamoxifen and Clomiphene intake ~ 2-3 weeks cycle, which was already stopped, prior to development of pt's symptoms. - H/O acute illness with generalized fatigue, malaise, URTI like symptoms and rash over the hands and chest, just prior to symptoms development, and upon further discussion, pt mentioned that few of his friends got sick around the same time. - Patient was seen the week prior by general ophthalmologist and was found to have SRF on OCT , diagnosed with CSCR and referred for retina evaluation. - ROS/ PMHx: Negative, healthy aside from the short illness described above - Denied any prior vision problems, similar episodes, trauma etc - VA Dsc OD: 20/400 OS:20/20 - anterior segment exam - unremarkable - posterior segment - macular RPE changes/ clumping with GA with no CME/ SRF or crystals OD, and unremarkable OS. - Pseudocolor and FAF photos: RPE changes/ clumps w/ GA and stippled autofluorescense OD, unremarkable OS. - HD SD-OCT: thickened choroid, thickened/ hypertrophied subfoveal RPE with hyper-reflective material on the apical side of the retinal pigment epithelium/apical debris, Subfoveal ellipsoid zone atrophy w/ intact ELM W/No CME or SRF OD, Unremarkable OS. - FA: Dye not available - ICG: deferred - mf-ERG & VF - patient rescheduled

Imaging device: Zeiss-Cirrus 4000

Condition/keywords: unilateral acute idiopathic maculopathy