Search results (875 results)

Apr 18 2025 by Chellarani Kumarasamy, MD

Fundus photo showed central posterior granuloma on the optic nerve

Condition/keywords: toxocara granuloma

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

Apr 7 2025 by Gustavo Uriel Fonseca Aguirre

B-mode ultrasound of a vitrectomized eye reveals emulsified silicone oil in the vitreous cavity, retinal detachment, and calcification of the retina and optic nerve head.

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

Condition/keywords: calcification, Retina detachment, vitrectomy

Apr 1 2025 by Korey Starkey

62-year-old patient presented with stable CRVO in the left eye. FA performed that day shows delayed AV transit is present, this has compensated with shunt vessels at the disc. However there is no evidence of active leakage. OS vision 20/25.

Photographer: Korey Starkey

Imaging device: Topcon

Condition/keywords: central retinal vein occlusion (CRVO), fundus photograph, optic nerve, shunts vessels, Topcon

Mar 25 2025 by Gustavo Uriel Fonseca Aguirre

Longitudinal B-scan echogram shows mildly elevated lesion overlying surface of optic nerve. A-scan shows regular internal structure and high reflectivity of lesion.

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

Condition/keywords: Melanocytoma

Jan 15 2025 by Virginia Gebhart

14 year female with suspicious nevus located adjacent to the optic nerve. Questionable orange pigment present and worsening SRF compared to previous photos/OCT. RPE atrophy also present from previous fluid. No elevation. Will continue observation. BCVA 20/25

Photographer: Virginia Gebhart, Retina Consultants of Carolina

Imaging device: Topcon 50DX

Condition/keywords: choroidal nevus, nevus

Dec 12 2024 by DANNA ALEXANDRA ALVIRDE AYALA

Ultra-wide field image of a 30-year-old man with coloboma.

Photographer: Danna Alexandra Alvirde-Ayala, Hospital Militar de Especialidades Oftalmológicas, Ciudad de México, México

Imaging device: Optos ultra-widefield

Condition/keywords: coloboma, optic nerve, retina

Oct 10 2024 by Philip Conkling, MD

Fundus photograph of infant with persistent fetal vasculature demonstrating large stalk emanating from the optic nerve head.

Condition/keywords: persistent fetal vasculature (PFV), persistent hyperplastic primary vitreous (PHPV)

Sep 24 2024 by Gustavo Uriel Fonseca Aguirre

A 14-year-old male with a history of blunt ocular trauma in the right eye presented partial avulsion of the optic nerve head and submacular hemorrhage that was managed with neumatic displacement.

Photographer: Gustavo U. Fonseca Aguirre, Fundación Hospital Nuestra Señora de la Luz, Ciudad de México

Condition/keywords: optic nerve head avulsion

Sep 8 2024 by Maria Antonia Orrego

We present the case of a 33 year-old woman with visual loss of her left eye since childhood. Fundus examination revealed a retinal arteriovenous malformation with vessels originating from the optic nerve and extending to the fovea and equator, corresponding to a type 3 retinal racemose hemangioma (A). Infrared reflectance imaging confirmed findings described in funduscopy (B). Spectral domain optical coherence tomography shows dilated vessels in the internal and external retinal layers and adjacent intraretinal fluid (C).

Photographer: Dr. Maria Antonia Orrego V, Universidad CES, Clinica Clofán, Medellín, Colombia

Imaging device: Optovue Solix

Condition/keywords: arteriovenous malformation, multimodal imaging, racemose hemangioma, retinal arteriovenous malformations

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

This is fundus photograph of a young 31 years male patient depicting Angioid streaks emanating from optic nerve towards the periphery and subretinal fibrosis. There is peau de orange appearance temporal to fovea with Salmon Spots in periphery. He was diagnosed to have Pseudoxanthoma Elasticum.

Photographer: Dr. Kanwaljeet Harjot Madan, M.S. (Ophthalmologist) Fellow in Vitrous & Retina. Thind Eye Hospital, Jalandhar City. Punjab. India

Imaging device: Zeiss Clarus

Condition/keywords: Angioid Streaks, fundus photograph, pseudoxanthoma elasticum (PXE)

Aug 8 2024 by Hemanth Murthy, MBBS, MD, FASRS

Multicolor image of left eye of 53 year female patient with decreased vision in left eye. Patient gives history of multiple joint swellings with multiple dental procedures due to calcification of the roots. She had type2 MNV demonstrated on OCT and OCTA. Her blood reports showed elevated serum phosphorus (6.4 mg/dl) with normal serum calcium, vitamin D and parathyroid hormone. Her fibroblast growth factor 23 was markedly elevated(>1500RU/ml).

Photographer: Mr Veda Vyas

Condition/keywords: Optic disc drusen and Angiod streaks

Aug 8 2024 by Hemanth Murthy, MBBS, MD, FASRS

Multicolor image of right eye of 53 year female patient with decreased vision in left eye. Patient gives history of multiple joint swellings with multiple dental procedures due to calcification of the roots. She showed type2 MNV on OCT and OCTA. Her blood reports showed elevated serum phosphorus (6.4 mg/dl) with normal serum calcium, vitamin D and parathyroid hormone. Her fibroblast growth factor 23 was markedly elevated(>1500RU/ml).

Photographer: Mr Veda Vyas

Condition/keywords: Optic disc drusen and Angiod streaks

Aug 8 2024 by Hemanth Murthy, MBBS, MD, FASRS

Autofluorescence image of left eye of 53 year female patient with decreased vision in left eye. Patient gives history of multiple joint swellings with multiple dental procedures due to calcification of the roots. She showed type 2 MNV in left eye on OCT and OCTA. Her blood reports showed elevated serum phosphorus (6.4 mg/dl) with normal serum calcium, vitamin D and parathyroid hormone. Her fibroblast growth factor 23 was markedly elevated(>1500RU/ml).

Photographer: Mr Veda Vyas

Condition/keywords: Optic disc drusen and Angiod streaks

Jul 27 2024 by Gokcen Deniz Gulpinar Ikiz

7 Year old girl presented with blurred vision on the left eye, with intermittent esotopia. She had been followed conservatively for intermittent esotropia on the left eye, recently advised for patching of the right eye. The vision is 1.0 on the right eye and 0.4 (Snellen) on the left eye. Anterior segment is natural bilaterally, except 20 PD esotropia on the left eye, with alternation and fixation. Refraction was +0.25 +0.25 x180 and +1.00-1.50 x60 on the right and left eyes respectively. Dilated fundus examination was natural on the right eye. However, there was a fibrotic stalk originating from the optic nerve head extending to the vitreous, terminating in the middle of the vitreous cavity, in a spider web configuration. Which also causes nasal dragging of the macula, leading to partial shallow detachment of the fovea nasally. Vitrectomy is advised for the left eye, with lens preserving approach, to preserve the current functional potential and the anatomy of the globe in long term.

Photographer: Gokcen Deniz Gulpinar Ikiz, Special Eye Clinic

Condition/keywords: amblyopia, posterior PFV, vitrectomy

Jun 21 2024 by BENITO VERGARA, MD

Montage of an angiography with fluorescein from the left eye of a 32 year-old male with diabetic retinopathy previously treated with panretinal photocoagulation, that shows leakage at optic nerve and upper nasal arcade.

Photographer: Benito Vergara, Asociación Para Evitar la Ceguera en México.

Imaging device: Zeiss Clarus 700

Condition/keywords: Angiography Montage, angiography with fluorescein, diabetic retinopathy, FA montage, fluorescein angiogram (FA), peripheral scars

May 28 2024 by Nishikant J Borse, MS, FMRF, FASRS

65-year-old female was referred for disc edema. An Autofluorescence Imaging was done which showed the autofluorescence of the optic nerve head drusen.

Photographer: Dr Nishikant Borse , Insight eye Clinic , Mumbai

Imaging device: Topcon Triton

Condition/keywords: Autofluorescence imaging of Optic Disc Drusen

May 28 2024 by Nishikant J Borse, MS, FMRF, FASRS

65-year-old female was referred for disc edema. An Autofluorescence Imaging was done which showed the autofluorescence of the optic nerve head drusen.

Photographer: Dr Nishikant Borse , Insight eye Clinic , Mumbai

Imaging device: Topcon Triton

Condition/keywords: Autofluorescence imaging of Optic Disc Drusen

May 13 2024 by Gabrielle Hallai

The left most figure demonstrates a normal pattern VEP response. The waveform is composed of a negative N75 peak, a positive P100 peak, and another negative N135 peak. The timing and amplitude of this response can be compared to determine if optic nerve/post-retinal visual pathways are functioning normally or abnormally. The second figure contains examples of a normal flash VEP response. In this case, a three channel VEP was completed which can help to determine chiasmal abnormalities. The major consistent component to assess in the flash VEP is the positive P2 peak that occurs around 120 ms. Pattern VEP responses were recorded using the Diagnosys pattern VEP protocol on a CRT monitor. Flash VEP responses were recorded using the Diagnosys ColorDome stimulator.

Photographer: Gabrielle Hallai, PhD, Cleveland Clinic Cole Eye Institute

Condition/keywords: flash VEP, pattern VEP, VEP, visual evoked potential

May 8 2024 by Virginia Gebhart

13 year old female with suspicious appearing choroidal nevus. High risk features present, adjacent to optic nerve, questionable orange pigment, SRF. No significant elevation on ultrasound. Will follow up with serial exams.

Photographer: Virginia Gebhart

Imaging device: Optos California

Condition/keywords: choroidal nevus, nevus

Apr 6 2024 by Hector Gabriel Moreno Solano, MD, MHA

Optic Nerve laser scan image reconstruction of a 57-year-old male presented for an ophthalmological evaluation with a chief complaint of progressive visual loss. Indirect ophthalmoscopy revealed proliferative diabetic retinopathy, without macular edema, and a hyperpigmented lesion at the optic disc which corresponds to a melanocytoma.

Photographer: Héctor Gabriel Moreno-Solano, MD, MHA

Imaging device: Mirante

Condition/keywords: intraocular tumor, macular edema, melanocytoma, optic nerve

Apr 6 2024 by Hector Gabriel Moreno Solano, MD, MHA

Fundus photograph of a 57-year-old male presented for an ophthalmological evaluation with a chief complaint of progressive visual loss. Indirect ophthalmoscopy revealed proliferative diabetic retinopathy, without macular edema, and a hyperpigmented lesion at the optic disc which corresponds to a melanocytoma.

Photographer: Héctor Gabriel Moreno-Solano

Imaging device: Clarus 700

Condition/keywords: diabetic retinopathy, intraocular tumor, melanocytoma, optic nerve

Apr 6 2024 by Hector Gabriel Moreno Solano, MD, MHA

Optic nerve photo of a 53-year-old woman with proliferative diabetic retinopathy.

Photographer: Héctor Gabriel Moreno-Solano, MD, MHA

Imaging device: Smartphone (IPhone 11 pro max)

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

Mar 14 2024 by César Adrián Gómez Valdivia, MD

Benign neoplasm with seldom malignant transformation.

Photographer: Erika Paulina Ornelas Cazares

Imaging device: TOPCON TRC-50DX

Condition/keywords: disc, Melanocytoma, Nerve, Optic, optic disc melanocytoma

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