Search results (273 results)

Apr 18 2025 by DR Rohit Gupta

The **myelinated nerve fibers of the optic disc** (also known as **medullated nerve fibers**) are retinal nerve fibers that retain their myelin sheath as they pass through the optic nerve head. Normally, retinal nerve fibers are unmyelinated to allow for light transparency, but in some cases, myelination extends anteriorly into the retina, appearing as a striking white, feathery patch on the optic disc or peripapillary retina. ### **Key Features:** 1. **Appearance:** - Dense, white, striated patches with feathery edges. - Typically located at the superior or inferior pole of the optic disc. - May obscure retinal vessels underneath. 2. **Clinical Significance:** - Usually **benign** and asymptomatic. - **Congenital** (present at birth or early childhood). - Rarely associated with **visual field defects** (e.g., scotomas corresponding to the area of myelination). - Occasionally linked with **high myopia** or **amblyopia** if extensive. 3. **Pathophysiology:** - Failure of oligodendrocytes or Schwann cells to stop myelination at the lamina cribrosa. - Normally, myelination stops at the optic nerve head, but in this condition, it extends into the retina. 4. **Diagnosis:** - **Fundoscopy:** Classic white, feathery appearance. - **Optical Coherence Tomography (OCT):** Shows thickened retinal nerve fiber layer (RNFL). - **Visual Field Testing:** May detect defects if large. 5. **Differential Diagnosis:** - Optic disc edema - Cotton wool spots - Retinoblastoma (rarely, but must be ruled out in children) 6. **Management:** - No treatment required if asymptomatic. - Monitor for amblyopia in children. - Rare cases with significant visual impairment may need further evaluation. ### **Fun Fact:** Myelinated nerve fibers are seen in **~0.5-1%** of the population and are usually an incidental finding.

Photographer: Dr Rohit gupta

Imaging device: Samsung S21

Condition/keywords: Medulated Nerve fibre, Medullated Nerve fibres, myelinated nerve fibers, Myelinated Nerve Fibres, optic disc drusen

Mar 22 2025 by Deepak Bhojwani, MS

A fundus image of an asymptomatic 64 year old male with large horseshoe shaped breaks in inferonasal quadrant on posterior pole, an unusual location for retinal breaks.

Photographer: DR DEEPAK BHOJWANI

Condition/keywords: horseshoe tear, posterior pole break, retinal break

Mar 6 2025 by Gerardo - Montante Montelongo, MD

Fundus photograph of an 83-year-old male with a history of Diabetes, smoking, cataract surgery on the right eye in 2022, and open-angle glaucoma. Asymptomatic. Indirect ophthalmoscopy revealed 80% excavation, peripapillary atrophy, and a hyperpigmented perifoveal lesion with 35% atrophy, 10% drusen, and 5.1 mm diameter, corresponding to a CHRPE. At multimodal imaging, FFA shows hypoautofluorescence of the lesion, OCT shows preservation of internal retinal layers, atrophy of external retinal layer, with an RPE disruption, and posterior shadowing. USG shows a flat hyperechoic lesion 5.1 mm in diameter and 1.32 mm in thickness, solid and with high internal reflectance.

Photographer: Gerardo Montante-Montelongo, MD, Mexican Institute of Ophthalmology

Imaging device: Clarus 700

Condition/keywords: congenital hypertrophy of the retinal pigment epithelium (CHRPE), multimodal imaging

Feb 10 2025 by Virginia Gebhart

10 year old female referred for amelanotic lesion in the inferior macula. Clinical exam and ultrasound consistent with choroidal osteoma. Pt is asymptomatic, will observe.

Photographer: Virginia Gebhart, Retina Consultants of Carolina

Imaging device: Topcon 50DX

Condition/keywords: choroidal osteoma

Feb 6 2025 by Jack B Margines, MD, MHCI

Peripheral patchy hyperfluorescence is seen on this early image of ICG-A on a 53-year-old asymptomatic with an extramacular circumscribed choroidal hemangioma.

Photographer: W Ryan Miliam, CRA, OCT-C, University of California, Irvine Gavin Herbert Eye Institute

Imaging device: Optos

Condition/keywords: choroidal hemangioma, indocyanine green (ICG) angiography

Feb 6 2025 by Jack B Margines, MD, MHCI

SD-OCT of an extramacular Circumscribed Choroidal Hemangioma in an asymptomatic 53 year-old female

Photographer: Ryan Milam, University of California, Irvine Gavin Herbert Eye Institute

Imaging device: Zeiss Cirrus

Condition/keywords: Circumscribed Choroidal Hemangioma, OCT

Jan 13 2025 by Virginia Gebhart

25 year-old female referred for melanocytoma of optic disc. Lesion is benign, no treatment necessary. Pt asymptomatic.

Photographer: Virginia Gebhart, Retina Consultants of Carolina

Imaging device: Topcon 50DX

Condition/keywords: benign melanocytoma, melanocytoma, optic disc melanocytoma

Nov 13 2024 by Virginia Gebhart

42 year old female with telangiectatic vessels and vascular sheathing. FA showed mild leakage with areas of peripheral non-perfusion. Pt is asymptomatic without inflammation in the vitreous. No history of systemic inflammatory disease. Will observe.

Photographer: Virginia Gebhart, Retina Consultants of Carolina

Imaging device: Optos California

Condition/keywords: retinal telangiectasia, telangiectatic vessels, vascular sheathing of retina

Oct 23 2024 by Virginia Gebhart

62 year old female with bullseye RPE changes and flecks, mottled FAF, and silent choroid on FA consistent with late onset Stargardt's Disease. Pt is asymptomatic with 20/20 vision OU at this time

Photographer: Virginia Gebhart, Retina Consultants of Carolina

Imaging device: Optos California

Condition/keywords: Stargardt disease, Stargardts Disease

Oct 16 2024 by Virginia Gebhart

74 year old female with bone spicule pigmentation associated with Retinitis Pigmentosa. Pt diagnosed at age 53, relatively asymptomatic prior to diagnosis. Pt reports gradual vision loss over 10+ years. BCVA 20/40

Photographer: Virginia Gebhart, Retina Consultants of Carolina

Imaging device: Optos California

Condition/keywords: bone spicule, retinitis pigmentosa, retinitis pigmentosa (RP) dystrophy

Oct 11 2024 by Virginia Gebhart

55 year old male s/p RD repair with SB and SO in Mexico June 2023. Questionable foreign body inferior vitreous base. Pt asymptomatic, had no previous knowledge of IOFB.

Photographer: Virginia Gebhart, Retina Consultants of Carolina

Imaging device: Optos California

Condition/keywords: intraocular foreign body, IOFB, scleral buckle

Sep 17 2024 by Nicolas A Yannuzzi, MD

The PD simulates Stargardt disease/fundus flavimaculatus with irregular yellow-white flecks scattered throughout the posterior pole. Some lesions extend beyond the retinal vascular arcades.

Condition/keywords: inherited retinal disease, pattern dystrophy

Sep 16 2024 by Sriharanathan Poopalaratnam, MD,FRCS

Fundus photograph of a 13-year-old boy asymptomatic accidental finding of unilateral, extramacular oval hypopigmented lesion, with its tip directed toward the central macula, suggestive of a "torpedo" lesion in the nonclassical location.

Photographer: Ms.Samitha

Condition/keywords: torpedo Retinopathy

Aug 29 2024 by César Adrián Gómez Valdivia, MD

Inferior retinal vasoproliferative tumor found in a 66 year-old female patient. Asymptomatic.

Photographer: @eyemissu2

Imaging device: California ICG OPTOS

Condition/keywords: Vasoproliferative Tumor

Aug 12 2024 by Virginia Gebhart

77 year old female with symmetrical retinal flecks consistent with hereditary dystrophy. Unable to complete genetic testing today, will consider in the future. Pt Asymptomatic, Dcc 20/20 OU

Photographer: Virginia Gebhart

Imaging device: Optos California

Condition/keywords: fundus flavimaculatus

Jun 18 2024 by KANWALJEET HARJOT MADAN, M.S. (Ophthalmology), FAICO (Vitreous - Retina)

This is a fundus photo depicting ruptured Retinal Artery Macroaneurysm (RAM) in the left eye of a 63 years old female. RAM is an acquired saccular or fusiform dilatation of the retinal arterioles that usually occur within the first three orders of bifurcation. The Superotemporal artery is the most common location. RAM may be asymptomatic or cause a number of complications such as macular edema, serous macular detachment, and hemorrhages.

Photographer: Dr Kanwaljeet Harjot Madan

Condition/keywords: Haemorrhage, macroaneurysm, retinal arteriole

May 30 2024 by Virginia Gebhart

33 year old female with regressed osteoma OS s/p focal laser, TTT and PDT (first treatment in 2013). Vision 20/20, pt remains asymptomatic.

Photographer: Virginia Gebhart

Imaging device: Topcon 50DX

Condition/keywords: choroidal osteoma

May 15 2024 by Virginia Gebhart

74 year old female with choroidal folds s/p external beam radiation 11/2023. Choroidal infiltration and resolved SRF most likely secondary to Chronic Lymphocytic Leukemia. Pt remains asymptomatic.

Photographer: Virginia Gebhart

Imaging device: Topcon 50DX

Condition/keywords: after proton beam irradiation, choroidal folds

May 10 2024 by Ethan K Sobol, MD

An asymptomatic patient with biopsy proven pseudoxanthoma elasticum. Both eyes had prominent peripapillary angioid streaks and a peau d'orange fundus appearance in the temporal macula.

Condition/keywords: angioid streaks, peau d'orange fundus, pseudoxanthoma elasticum (PXE)

Feb 21 2024 by Virginia Gebhart

65 year old female with optic nerve pit. Asymptomatic, continued observation.

Photographer: Virginia Gebhart

Imaging device: Topcon TRC 50DX

Condition/keywords: congenital optic nerve pit, Optic nerve pit

Feb 20 2024 by Soobien Lee

Optos color fundus photograph of a 35-year-old asymptomatic female with no ocular or medical history with stable and chronic appearing torpedo-shaped macula lesion in the left eye.

Photographer: Peter Sotirakos, Elman Retina Group

Imaging device: Optos Ultra-Widefield Imaging

Condition/keywords: macula, Optos, torpedo maculopathy

Feb 20 2024 by Soobien Lee

Optos fundus autofluorescence photograph of a 35-year-old asymptomatic female with no ocular or medical history with stable and chronic appearing torpedo-shaped macula lesion in the left eye.

Photographer: Peter Sotirakos, Elman Retina Group

Imaging device: Optos Ultra-Widefield Autoflurescence Imaging

Condition/keywords: autofluorescence imaging, genetics, macula, maculopathy, Optos, torpedo maculopathy

Feb 18 2024 by Austin Pereira, MD

Fundus photograph of a 60 year-old asymptomatic female with a choroidal macrovessel.

Photographer: Austin Pereira, University of Toronto, Toronto, Ontario, Canada

Condition/keywords: choroid

Feb 14 2024 by Virginia Gebhart

61 year old female with a suspicious choroidal nevus involving the optic nerve head. Patient asymptomatic, will continue to observe.

Photographer: Virginia Gebhart

Imaging device: Topcon TRC 50DX

Condition/keywords: choroidal nevus, nevus

Jan 4 2024 by Virginia Gebhart

13 year old female with inactive CNV. Increased pigment 360 at 1 year follow up. No inflammation or SRF, pt remains asymptomatic

Photographer: Virginia Gebhart

Imaging device: Optos California

Condition/keywords: choroidal neovascularization (CNV), peripapillary choroidal neovascularization (PPCNVM)