Search results (292 results)

  • Traction in Proliferative Diabetic Retinopathy

    Jun 9 2025 by Malvika Singh

    Fundus photograph of a 44 year old with uncontrolled diabetes showing fibrovascular proliferation and traction with details of disc and macula obscured with sclerosed vessels in the periphery.

    Photographer: Dr Malvika Singh, Retina Foundation, Ahmedabad, India

    Imaging device: Mirante SLO/OCT

    Condition/keywords: proliferative diabetic retinopathy (PDR), TRACTION

  • Neovascularization of the Disc

    Jun 3 2025 by Scott D Walter, MD, MSc, FASRS

    Near-infrared (NIR) en face OCT image showing neovascularization of the disc (NVD) in a patient with type II diabetes mellitus, complicated by proliferative diabetic retinopathy (PDR).

    Imaging device: Heidelberg Spectralis

    Condition/keywords: Diabetes, Heidelburg Spectralis, microaneurysms, Neovascularisation at the Disc (NVD), NEOVASCULARISATION OF DISC, OCT EN FACE, proliferative diabetic retinopathy (PDR)

  • High Risk Proliferative Diabetic Retinopathy with Sub-hyaloid Hemorrhage

    May 13 2025 by Anupama Kiran Kumar

    This image shows a case of high risk proliferative diabetic retinopathy. The retina is unlasered with a taut posterior hyaloid and a sub-hyaloid hemorrhage at the macula and along the arcades ,sparing the fovea.

    Photographer: Mr Pratap

    Imaging device: Mirante SLO/OCT (Nidek Co., Gamagori, Japan)

    Condition/keywords: Diabetes, Diabetic Retinopathy, proliferative diabetic retinopathy (PDR), subhyaloid hemorrhage

  • Advanced Proliferative Diabetic Retinopathy

    Apr 9 2025 by Gustavo Uriel Fonseca Aguirre

    B-mode ultrasound of a patient with long-standing poorly controlled diabetes demonstrates characteristic findings of advanced proliferative diabetic retinopathy. The examination reveals moderate vitreous hemorrhage appearing as diffuse hyperechoic opacities throughout the vitreous cavity, along with a posterior hyaloid membrane densely infiltrated by hemorrhagic material, showing irregular thickening and increased reflectivity. A mild subhyaloid hemorrhage is visible as a subtle hyphema-like space anterior to the retinal surface. The study documents a total tractional retinal detachment, evidenced by rigid retinal folds with clear insertion points of vitreous strands, accompanied by a significant subretinal hemorrhage seen as a prominent hyperechoic collection beneath the elevated retina. These findings collectively illustrate the severe vitreoretinal interface pathology characteristic of end-stage diabetic eye disease, with predominant tractional components and distinct echographic stratification of hemorrhagic layers - from anterior vitreous involvement to deeper subretinal blood accumulation.

    Photographer: Gustavo U. Fonseca Aguirre, Hospital Conde de Valenciana, Ciudad de México

    Condition/keywords: diabetic retinopathy, tractional retinal detachment, Vitreous hemorrhage

  • Moderate Nonproliferative Diabetic Retinopathy

    Mar 13 2025 by Drew Mitchell

    Fluorescein angiography on a patient with Moderate Nonproliferative Diabetic Retinopathy at 5 minutes.

    Photographer: Drew Mitchell OCT-C

    Imaging device: Optos California

    Condition/keywords: Diabetes, ischemia, nonproliferative diabetic retinopathy, OPTOS CALIFORNIA

  • Moderate Nonproliferative Diabetic Retinopathy

    Mar 13 2025 by Drew Mitchell

    Fluorescein angiography on a patient with Moderate Nonproliferative Diabetic Retinopathy at 5 minutes.

    Photographer: Drew Mitchell OCT-C

    Imaging device: Optos California

    Condition/keywords: Diabetes, nonproliferative diabetic retinopathy, OPTOS CALIFORNIA, retinal ischemia

  • Multimodal Imaging in CHRPE

    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

  • Proliferative Diabetic Retinopathy S/P Pan Retinal Photocoagulation

    Mar 4 2025 by Prithvi Chandrakanth

    A 52-year-old female patient presented with complaints of diminishing vision, compounded by uncontrolled diabetes mellitus. Her Fundus examination revealed proliferative diabetic retinopathy, characterized by neovascularization of the disc and elsewhere, and sclerosed vessels. To address this, Pan Retinal Photocoagulation was performed, and the condition stabilized, halting the progression of the disease.

    Photographer: DR PRITHVI CHANDRAKANTH, DR CHANDRAKANTH NETHRALAYA, KOZHIKODE, KERALA, INDIA

    Imaging device: EIDON

    Condition/keywords: Diabetic Retinopathy, Neovascularisation at the Disc (NVD), neovascularization of the disc (NVD), NVD, pan-retinal photocoagulation (PRP), PDR, PDR with NVE (periphery), PRP

  • Proliferative Diabetic Retinopathy

    Mar 1 2025 by Neeket R. Patel, MD

    A fundus photograph of a 28-year-old male monocular patient diagnosed with proliferative diabetic retinopathy, who is highly motivated to pursue retinal surgery. This case presents a unique challenge in both management and communication, given the patient's strong desire for intervention and the guarded prognosis for visual improvement.

    Condition/keywords: Diabetes, membranes, retinopathy, Traction retinal detachment

  • MIDD (Maternally Inherited Diabetes and Deafness)

    Feb 25 2025 by Virginia Gebhart

    53 year old female with confirmed MIDD (genetic testing at Emory). Vision is stable with progressing GA but still central sparing OU. No evidence of choroidal neovascularization. Moderate myopia.

    Photographer: Virginia Gebhart, Retina Consultants of Carolina

    Imaging device: Topcon 50DX

    Condition/keywords: geographic atrophy, Maternally inherited diabetes and deafness (MIDD), MIDD

  • Bilateral Proliferative Diabetic Retinopathy OU

    Feb 21 2025 by Drew Mitchell

    OCT-Angiography 8x8 Montage OU. PDR with active NVE OD. 37 year old male with no visual complaints. Vision is 20/20 in both eyes.

    Photographer: Drew Mitchell OCT-C

    Imaging device: Zeiss Cirrus 5000

    Condition/keywords: CIRRUS 5000 ANGIOPLEX, Diabetes, NVE, OCT Angiography, proliferative diabetic retinopathy (PDR)

  • Vascular maze- Proliferative Diabetic Retinopathy

    Feb 7 2025 by Hemanth Murthy, MBBS, MD, FASRS

    OCTA image left eye. A 32 year male with history of blurring of vision in right eye since 4 months. History of Diabetes and Hypertension since 2 years. Vision 6/36 in right eye and 6/9 in left eye

    Photographer: Veda Vyas

    Condition/keywords: proliferative diabetic retinopathy (PDR)

  • Vascular Maze-Proliferative Diabetic Retinopathy

    Feb 7 2025 by Hemanth Murthy, MBBS, MD, FASRS

    OCTA image right eye-A 32 year male with history of blurring of vision in right eye since 4 months. History of Diabetes and Hypertension since 2 years. Vision 6/36 in right eye and 6/9 in left eye

    Photographer: Veda Vyas

    Condition/keywords: OCT Angiography, proliferative diabetic retinopathy (PDR)

  • Vascular Maze-Proliferative Diabetic Retinopathy

    Feb 7 2025 by Hemanth Murthy, MBBS, MD, FASRS

    Fundus photo left eye. A 32 year male with history of blurring of vision in right eye since 4 months. History of Diabetes and Hypertension since 2 years. Vision 6/36 in right eye and 6/9 in left eye

    Photographer: Veda Vyas

    Condition/keywords: proliferative diabetic retinopathy (PDR)

  • Vascular Maze-Proliferative Diabetic Retinopathy

    Feb 7 2025 by Hemanth Murthy, MBBS, MD, FASRS

    Fundus photo of right eye. A 32 year male with history of blurring of vision in right eye since 4 months. History of Diabetes and Hypertension since 2 years. Vision 6/36 in right eye and 6/9 in left eye

    Photographer: Veda Vyas

    Condition/keywords: proliferative diabetic retinopathy (PDR)

  • Subhyaloid Hemorrhage

    Jan 22 2025 by DR Rohit Gupta

    48 year old female presented with right eye diminution of vision, on fundus examination a large hemorrhage was seen in subhyaloid space with multiple retinal hemorrhages. Patients was known case of diabetes with uncontrolled blood sugar level.

    Photographer: Dr Rohit gupta

    Imaging device: Samsung S21

    Condition/keywords: SUB ILM hemorrhage, subhyaloid blood, subhyaloid hemorrhage

  • Maternally-Inherited Diabetes and Deafness (MIDD) Syndrome

    Jan 12 2025 by Niloofar Piri, MD

    Fundus Autofluorescence image of right posterior pole in a 43 year old female who was referred for diabetic retinopathy evaluation, demonstrated multiple patches of hypoautrofluorescence surrounding the nerve and fovea. Please note that central fovea is spared. Granular hyper and hypoauto fluorescence is present in the macula and peripapillary region. She was noted to have hearing loss as well and after further evaluation was diagnosed with MIDD syndrome.

    Condition/keywords: Maternally inherited diabetes and deafness (MIDD), Maternally-inherited-diabetes-and-deafness-(MIDD) syndrome, Mitochondrial Disorder

  • MIDD (Maternally Inherited Diabetes and Deafness) - Left AF

    Nov 30 2024 by John S. King, MD

    Both right and left eyes have symmetrical ring of mottled hypo/hyper AF around the fovea and disc. The HyperAF areas correspond to RPE deposits on OCT as well as areas of blockage on FA, and drusenoid deposits seen on fundus photos 57 yo WF referred for AMD vs Pattern Dystrophy that was diagnosed 10 years ago. Reported some slow progressive vision loss in both eyes for distance and near. Denies nyctalopia or hemeralopia. Background medical history includes HTN, CVD, and DM. No family history of eye problems. Denied pentosan use. Anterior segment showed moderate cataracts (OD>OS). Posterior segment exam showed macular changes and mild NPDR. The macular appearance showed a symmetrical, paramacular ring of fleck-like drusenoid material with some faint focal areas of RPE hyperplasia. Fundus Photos, AF, OCT were performed as well as a gene test. Further questioning showed revealed that her mother and maternal grandmother had both diabetes mellitus and sensorineural hearing loss. The patient developed diabetes in her teens, and some high frequency hearing loss in her early twenties. She had not had a previous genetic test or diagnosis of MIDD. Gene testing is pending for the mitochondrial component. Invitae's retinal panel, which does not include mitochondrial disorders, only showed a variant of uncertain significance, HMCN1. I discussed this case with Dr. Freund, and it is similar to a the case report : Inoue M, Kiss S, Freund KB. MACULAR PIGMENT RINGS AS THE PRESENTING FINDING OF MITOCHONDRIAL MYOPATHY, ENCEPHALOPATHY, LACTIC ACIDOSIS, AND STROKELIKE EPISODES. Retin Cases Brief Rep. 2015 Fall;9(4):260-4. doi: 10.1097/ICB.0000000000000182. PMID: 26200388.

    Photographer: Grace Melton and Carley Gunn

    Imaging device: Clarus

    Condition/keywords: Macular Dystrophy, Maternally Inherited Diabetes and Deafness, MIDD, Mitochondrial Disorder

  • MIDD (Maternally Inherited Diabetes and Deafness) - Right AF

    Nov 30 2024 by John S. King, MD

    Both right and left eyes have symmetrical ring of mottled hypo/hyper AF around the fovea and disc. The HyperAF areas correspond to RPE deposits on OCT as well as areas of blockage on FA, and drusenoid deposits seen on fundus photos. Disc drusen in right eye present as HyperAF spot 57 yo WF referred for AMD vs Pattern Dystrophy that was diagnosed 10 years ago. Reported some slow progressive vision loss in both eyes for distance and near. Denies nyctalopia or hemeralopia. Background medical history includes HTN, CVD, and DM. No family history of eye problems. Denied pentosan use. Anterior segment showed moderate cataracts (OD>OS). Posterior segment exam showed macular changes and mild NPDR. The macular appearance showed a symmetrical, paramacular ring of fleck-like drusenoid material with some faint focal areas of RPE hyperplasia. Fundus Photos, AF, OCT were performed as well as a gene test. Further questioning showed revealed that her mother and maternal grandmother had both diabetes mellitus and sensorineural hearing loss. The patient developed diabetes in her teens, and some high frequency hearing loss in her early twenties. She had not had a previous genetic test or diagnosis of MIDD. Gene testing is pending for the mitochondrial component. Invitae's retinal panel, which does not include mitochondrial disorders, only showed a variant of uncertain significance, HMCN1. I discussed this case with Dr. Freund, and it is similar to a the case report : Inoue M, Kiss S, Freund KB. MACULAR PIGMENT RINGS AS THE PRESENTING FINDING OF MITOCHONDRIAL MYOPATHY, ENCEPHALOPATHY, LACTIC ACIDOSIS, AND STROKELIKE EPISODES. Retin Cases Brief Rep. 2015 Fall;9(4):260-4. doi: 10.1097/ICB.0000000000000182. PMID: 26200388.

    Photographer: Grace Melton and Carley Gunn

    Imaging device: Clarus

    Condition/keywords: Macular Dystrophy, Maternally Inherited Diabetes and Deafness, MIDD, Mitochondrial Disorder

  • MIDD (Maternally Inherited Diabetes and Deafness) - Left FP

    Nov 30 2024 by John S. King, MD

    Both the right and left Eye have fairly symmetrical, extrafoveal drusenoid-like flecks and focal and faint areas of RPE hyperplasia (in addition to mild NPDR and PPA) 57 yo WF referred for AMD vs Pattern Dystrophy that was diagnosed 10 years ago. Reported some slow progressive vision loss in both eyes for distance and near. Denies nyctalopia or hemeralopia. Background medical history includes HTN, CVD, and DM. No family history of eye problems. Denied pentosan use. Anterior segment showed moderate cataracts (OD>OS). Posterior segment exam showed macular changes and mild NPDR. The macular appearance showed a symmetrical, paramacular ring of fleck-like drusenoid material with some faint focal areas of RPE hyperplasia. Fundus Photos, AF, OCT were performed as well as a gene test. Further questioning showed revealed that her mother and maternal grandmother had both diabetes mellitus and sensorineural hearing loss. The patient developed diabetes in her teens, and some high frequency hearing loss in her early twenties. She had not had a previous genetic test or diagnosis of MIDD. Gene testing is pending for the mitochondrial component. Invitae's retinal panel, which does not include mitochondrial disorders, only showed a variant of uncertain significance, HMCN1. I discussed this case with Dr. Freund, and it is similar to a the case report : Inoue M, Kiss S, Freund KB. MACULAR PIGMENT RINGS AS THE PRESENTING FINDING OF MITOCHONDRIAL MYOPATHY, ENCEPHALOPATHY, LACTIC ACIDOSIS, AND STROKELIKE EPISODES. Retin Cases Brief Rep. 2015 Fall;9(4):260-4. doi: 10.1097/ICB.0000000000000182. PMID: 26200388.

    Photographer: Grace Melton and Carley Gunn

    Imaging device: Clarus

    Condition/keywords: Macular Dystrophy, Maternally Inherited Diabetes and Deafness, MIDD, Mitochondrial Disorder

  • MIDD (Maternally Inherited Diabetes and Deafness) - Right FP

    Nov 30 2024 by John S. King, MD

    Both the right and left Eye have fairly symmetrical, extrafoveal drusenoid-like flecks and focal and faint areas of RPE hyperplasia (in addition to mild NPDR and PPA) 57 yo WF referred for AMD vs Pattern Dystrophy that was diagnosed 10 years ago. Reported some slow progressive vision loss in both eyes for distance and near. Denies nyctalopia or hemeralopia. Background medical history includes HTN, CVD, and DM. No family history of eye problems. Denied pentosan use. Anterior segment showed moderate cataracts (OD>OS). Posterior segment exam showed macular changes and mild NPDR. The macular appearance showed a symmetrical, paramacular ring of fleck-like drusenoid material with some faint focal areas of RPE hyperplasia. Fundus Photos, AF, OCT were performed as well as a gene test. Further questioning showed revealed that her mother and maternal grandmother had both diabetes mellitus and sensorineural hearing loss. The patient developed diabetes in her teens, and some high frequency hearing loss in her early twenties. She had not had a previous genetic test or diagnosis of MIDD. Gene testing is pending for the mitochondrial component. Invitae's retinal panel, which does not include mitochondrial disorders, only showed a variant of uncertain significance, HMCN1. I discussed this case with Dr. Freund, and it is similar to a the case report : Inoue M, Kiss S, Freund KB. MACULAR PIGMENT RINGS AS THE PRESENTING FINDING OF MITOCHONDRIAL MYOPATHY, ENCEPHALOPATHY, LACTIC ACIDOSIS, AND STROKELIKE EPISODES. Retin Cases Brief Rep. 2015 Fall;9(4):260-4. doi: 10.1097/ICB.0000000000000182. PMID: 26200388.

    Photographer: Grace Melton and Carley Gunn

    Imaging device: Clarus

    Condition/keywords: Macular Dystrophy, Maternally Inherited Diabetes and Deafness, MIDD, Mitochondrial Disorder

  • MIDD (Maternally Inherited Diabetes and Deafness) - OCT OD

    Nov 30 2024 by John S. King, MD

    OCT shows mild RPE deposit inferiorly (corresponds to area of FA blockage and HyperAF) and a focal area of iRORA with loss of EZ more superiorly (possibly due to regression of RPE deposit). No choroidal thickening (like in pachychoroid pigment epitheliopathy or cscr) 57 yo WF referred for AMD vs Pattern Dystrophy that was diagnosed 10 years ago. Reported some slow progressive vision loss in both eyes for distance and near. Denies nyctalopia or hemeralopia. Background medical history includes HTN, CVD, and DM. No family history of eye problems. Denied pentosan use. Anterior segment showed moderate cataracts (OD>OS). Posterior segment exam showed macular changes and mild NPDR. The macular appearance showed a symmetrical, paramacular ring of fleck-like drusenoid material with some faint focal areas of RPE hyperplasia. Fundus Photos, AF, OCT were performed as well as a gene test. Further questioning showed revealed that her mother and maternal grandmother had both diabetes mellitus and sensorineural hearing loss. The patient developed diabetes in her teens, and some high frequency hearing loss in her early twenties. She had not had a previous genetic test or diagnosis of MIDD. Gene testing is pending for the mitochondrial component. Invitae's retinal panel, which does not include mitochondrial disorders, only showed a variant of uncertain significance, HMCN1. I discussed this case with Dr. Freund, and it is similar to a the case report : Inoue M, Kiss S, Freund KB. MACULAR PIGMENT RINGS AS THE PRESENTING FINDING OF MITOCHONDRIAL MYOPATHY, ENCEPHALOPATHY, LACTIC ACIDOSIS, AND STROKELIKE EPISODES. Retin Cases Brief Rep. 2015 Fall;9(4):260-4. doi: 10.1097/ICB.0000000000000182. PMID: 26200388.

    Photographer: Grace Melton and Carley Gunn

    Imaging device: Zeiss Cirrus

    Condition/keywords: Macular Dystrophy, Maternally Inherited Diabetes and Deafness, MIDD, Mitochondrial Disorder

  • MIDD (Maternally Inherited Diabetes and Deafness) - OCT OS

    Nov 30 2024 by John S. King, MD

    Magnified section of radial scan through the left eye showing a focal nodular RPE deposit that corresponds to a focal drusenoid deposit in temporal macula, that HypoFLs and HyperAFs. Choroid not significantly thickened or thinned, and the nodular thickening may be just above a large outer choroid vessel?) 57 yo WF referred for AMD vs Pattern Dystrophy that was diagnosed 10 years ago. Reported some slow progressive vision loss in both eyes for distance and near. Denies nyctalopia or hemeralopia. Background medical history includes HTN, CVD, and DM. No family history of eye problems. Denied pentosan use. Anterior segment showed moderate cataracts (OD>OS). Posterior segment exam showed macular changes and mild NPDR. The macular appearance showed a symmetrical, paramacular ring of fleck-like drusenoid material with some faint focal areas of RPE hyperplasia. Fundus Photos, AF, OCT were performed as well as a gene test. Further questioning showed revealed that her mother and maternal grandmother had both diabetes mellitus and sensorineural hearing loss. The patient developed diabetes in her teens, and some high frequency hearing loss in her early twenties. She had not had a previous genetic test or diagnosis of MIDD. Gene testing is pending for the mitochondrial component. Invitae's retinal panel, which does not include mitochondrial disorders, only showed a variant of uncertain significance, HMCN1. I discussed this case with Dr. Freund, and it is similar to a the case report : Inoue M, Kiss S, Freund KB. MACULAR PIGMENT RINGS AS THE PRESENTING FINDING OF MITOCHONDRIAL MYOPATHY, ENCEPHALOPATHY, LACTIC ACIDOSIS, AND STROKELIKE EPISODES. Retin Cases Brief Rep. 2015 Fall;9(4):260-4. doi: 10.1097/ICB.0000000000000182. PMID: 26200388.

    Photographer: Grace Melton and Carley Gunn

    Imaging device: Zeiss Cirrus

    Condition/keywords: Macular Dystrophy, Maternally Inherited Diabetes and Deafness, MIDD, Mitochondrial Disorder

  • MIDD (Maternally Inherited Diabetes and Deafness) - Right FA (4 min)

    Nov 30 2024 by John S. King, MD

    Both eyes had similar FA findings. There was no dark choroid or signs of leakage. Granular staining around the fovea and disc were present, and the HypoAF areas corresponded to the drusenoid deposits that showed HyperAF. Mild MAs present due to NPDR 57 yo WF referred for AMD vs Pattern Dystrophy that was diagnosed 10 years ago. Reported some slow progressive vision loss in both eyes for distance and near. Denies nyctalopia or hemeralopia. Background medical history includes HTN, CVD, and DM. No family history of eye problems. Denied pentosan use. Anterior segment showed moderate cataracts (OD>OS). Posterior segment exam showed macular changes and mild NPDR. The macular appearance showed a symmetrical, paramacular ring of fleck-like drusenoid material with some faint focal areas of RPE hyperplasia. Fundus Photos, AF, OCT were performed as well as a gene test. Further questioning showed revealed that her mother and maternal grandmother had boith diabetes mellitus and sensorineural hearing loss. The patient developed diabetes in her teens, and some high frequency hearing loss in her early twenties. She had not had a previous genetic test or diagnosis of MIDD. Gene testing is pending for the mitochondrial component. Invitae's retinal panel, which does not include mitochondrial disorders, only showed a variant of uncertain significance, HMCN1. I discussed this case with Dr. Freund, and it is similar to a the case report : Inoue M, Kiss S, Freund KB. MACULAR PIGMENT RINGS AS THE PRESENTING FINDING OF MITOCHONDRIAL MYOPATHY, ENCEPHALOPATHY, LACTIC ACIDOSIS, AND STROKELIKE EPISODES. Retin Cases Brief Rep. 2015 Fall;9(4):260-4. doi: 10.1097/ICB.0000000000000182. PMID: 26200388.

    Photographer: Grace Melton and Carley Gunn

    Imaging device: Clarus

    Condition/keywords: Macular Dystrophy, Maternally Inherited Diabetes and Deafness, MIDD, Mitochondrial Disorder

  • MIDD (Maternally Inherited Diabetes and Deafness) - Left FA (7 min)

    Nov 30 2024 by John S. King, MD

    Both eyes had similar FA findings. There was no dark choroid or signs of leakage. Granular staining around the fovea and disc were present, and the HypoAF areas corresponded to the drusenoid deposits that showed HyperAF. Mild MAs present due to NPDR 57 yo WF referred for AMD vs Pattern Dystrophy that was diagnosed 10 years ago. Reported some slow progressive vision loss in both eyes for distance and near. Denies nyctalopia or hemeralopia. Background medical history includes HTN, CVD, and DM. No family history of eye problems. Denied pentosan use. Anterior segment showed moderate cataracts (OD>OS). Posterior segment exam showed macular changes and mild NPDR. The macular appearance showed a symmetrical, paramacular ring of fleck-like drusenoid material with some faint focal areas of RPE hyperplasia. Fundus Photos, AF, OCT were performed as well as a gene test. Further questioning showed revealed that her mother and maternal grandmother had boith diabetes mellitus and sensorineural hearing loss. The patient developed diabetes in her teens, and some high frequency hearing loss in her early twenties. She had not had a previous genetic test or diagnosis of MIDD. Gene testing is pending for the mitochondrial component. Invitae's retinal panel, which does not include mitochondrial disorders, only showed a variant of uncertain significance, HMCN1. I discussed this case with Dr. Freund, and it is similar to a the case report : Inoue M, Kiss S, Freund KB. MACULAR PIGMENT RINGS AS THE PRESENTING FINDING OF MITOCHONDRIAL MYOPATHY, ENCEPHALOPATHY, LACTIC ACIDOSIS, AND STROKELIKE EPISODES. Retin Cases Brief Rep. 2015 Fall;9(4):260-4. doi: 10.1097/ICB.0000000000000182. PMID: 26200388.

    Photographer: Grace Melton and Carley Gunn

    Imaging device: Clarus

    Condition/keywords: Macular Dystrophy, Maternally Inherited Diabetes and Deafness, MIDD, Mitochondrial Disorder