Search results (87 results)

Nov 18 2024 by Edward F. Hall, MD, FASRS

Left fundus photograph of a 44-year-old man showing patchy ischemic retinal whitening associated with Sturge-Weber Syndrome. The precise cause of this rare complication remains unclear, but it may be linked to choroidal vascular congestion and a compartment syndrome-like effect on the local retinal arteriolar circulation. OCT imaging confirmed inner retinal ischemia and thickening

Photographer: Karissa Kuhl

Imaging device: Optos

Condition/keywords: retinal ischemia, Sturge Weber Syndrome

May 14 2024 by Eloy Mata-Cortes, MD

Color image capturing the left eye of a 32-year-old female. Despite a negative ophthalmological and medical history, she reported three days of blurred vision and a paracentral scotoma in her left eye, while maintaining central vision. The image reveals retinal whitening, extends from the parafoveal region to the inferotemporal arcade indicative of cilioretinal artery occlusion. Following this observation, the patient was referred for systemic assessment to explore the underlying etiology of the occlusion.

Photographer: Eloy Mata-Cortes, MD, Instituto Mexicano de Oftalmología, Querétaro, México

Imaging device: Nidek Mirante

Condition/keywords: cilioretinal artery occlusion, oclussion, retinal whitening

Nov 16 2023 by Gabriel Costa Andrade, PhD

Fundus photograph of an 62-year-old man with retinal whitening and a cherry red spot due to Central Retinal Artery Occlusion.

Photographer: Gabriel Andrade

Condition/keywords: Central Retinal Artery Occlusion, central retinal artery occlusion (CRAO), Retina

Jun 28 2023 by Maneesh M Bapaye, MD, MBA

A 34 year old male patient presented with sudden onset vision loss of 1 week duration. Visual acuity at presentation was 20/200. Fundus examination revealed diffuse retinal whitening with sparing of papillomacular bundle and fovea due to patent cilioretinal artery. Autofluorescence shows peripheral hypoAF, patent capillaries can be seen only in area of cilioretinal supply, OCT shows thickening of inner retinal layers temporal to fovea Systemic examination revealed that patient had valvular heart disease with multiple valves involved.

Photographer: Maneesh Bapaye

Condition/keywords: cilioretinal sparing, CRAO, multimodal imaging

Sep 22 2021 by Luiz Guilherme Freitas, MD, MsC, PhD

Fundus photograph of a 30-year-old male patient with blunt injury to the globe. Commotio retinae is retinal whitening/opacification that results from a blunt injury. The ocular findings will often resolve in a matter of days to weeks. Vision loss can result from commotio involving the posterior pole (historically referred to as Berlin’s edema). Clinical findings of commotio include the characteristic retinal whitening. Commotio may result in significant vision loss that can be transient. Healing can result in pigmentary changes and retinal thinning which may be associated with poor visual recovery if the area of involvement is macular.

Photographer: Diogo Melo, Santa Luzia Eye Hospital Recife - PE – Brazil

Condition/keywords: Berlin's edema, blunt trauma, commotio retinae, retinal whitening

Mar 12 2021 by Kushal S Delhiwala, MBBS, MS, FMRF,FICO, FAICO

Fundus photographs of 33-year-old healthy male with right eye acute CRAO of 12 hours duration showing cattle trucking, extensive retinal whitening and cherry red spot (left image). Right image 18 hours later showing reduced extent of retinal whitening and absent cattle trucking, suggestive of natural restoration of perfusion.

Photographer: Kushal Delhiwala, Netralaya superspeciality eye hospital, Ahmedabad, Gujarat,India

Imaging device: Optos Daytona

Condition/keywords: cattle trucking, central retinal artery occlusion (CRAO), cherry red spot

Jan 22 2021 by Renata Garcia Franco, Md

65-year-old male, history of uncontrolled systemic arterial hypertension. Segmentation of blood in retinal arterioles, retinal whitening and cherry red spot.

Photographer: Fatima Hernandez, Instituto de la Retina del Bajio SC

Imaging device: Zeiss

Condition/keywords: central retinal artery occlusion (CRAO)

Oct 28 2020 by Fang Helen Mi

Fundus photograph of an 61-year-old Chinese male showing central retinal artery occlusion with cilioretinal sparing. Photo shows diffuse ischemic retinal whitening and box-carring of the retinal arterioles.

Condition/keywords: central retinal artery occlusion (CRAO), cilioretinal sparing

Oct 6 2020 by Michael Izzo, MD

Left image: fundus photograph of a 39-year-old male with rheumatoid arthritis found to have ophthalmic artery occlusion depicting boxcar segmentation of blood in retinal vasculature and macular ischemia demonstrated by retinal whitening without cherry red fovea. Right image: early phase fluorescein angiography demonstrating patchy choroidal filling, arterial non-perfusion and optic nerve head leakage.

Photographer: Karen Rivera, COA; Washington National Eye Center

Condition/keywords: fluorescein angiogram (FA), ophthalmic artery occlusion, rheumatoid arthritis

Sep 23 2020 by Nimesh A. Patel, MD, FASRS

Fundus photo showing peri-vascular inflammation of both arteries and veins with translucent exudation (yellow arrow). Superior nasally, there is classic retinal whitening with retinal hemorrhages superior. This patient was found to have a low CD4 count and a diagnosis of AIDS was made.

Condition/keywords: cytomegalovirus (CMV), HIV, uveitis

Nov 17 2019 by John S. King, MD

60-year-old white female presented with five days of acute vision loss in the right eye. She was seen initially by referring doctor after hours five days ago and diagnosed with a CRAO and sent to ED to be evaluated stroke team. Right ICA was 100% closed but completely bypassed. She called four days later c/o redness and eye pain; at this point prominent iris vessels were seen, and she was sent to us. Her background history includes a diagnosis of moyamoya (underwent bilateral cerebral artery bypass 2015); atorvastatin for hypercholesterolemia; ASA; no hx of HTN or heart disease. She had a scleral buckle repair OD in 2017 and later developed a thick ERM, which was repaired in 2018; on her previous visit her acuity was noted at 20/40. On presentation her visual acuity was HM OD and 20/15 OS. IOP was 8 OD and 10 OS. There were prominent iris vessels in the right eye, no cell or flare, and an IOL. The posterior segment exam showed diffuse retinal whitening with attenuated vessels and boxcarring; there was sparing retinal whitening in a central area of the macula that appeared to be supplied by a cilio-retina artery. The FA showed very slow filling of the retinal vessels; there was some early perfusion secondary to the cilio-retinal artery. At 7 minutes there was still significant areas of non-perfusion, as well as macular ischemia. Avastin was administered, and one week later, PRP was performed. On the day PRP was performed, the irregular iris vessels had regressed completely. She said that she had a "sliver" of vision centrally in that eye; her acuity was CF 2' and IOP 12.

Photographer: Gretchen Harper

Imaging device: Topcon

Condition/keywords: central retinal artery occlusion (CRAO), cilioretinal sparing, moyamoya, neovascularization of iris (NVI)

Nov 17 2019 by John S. King, MD

60-year-old white female presented with five days of acute vision loss in the right eye. She was seen initially by referring doctor after hours five days ago and diagnosed with a CRAO and sent to ED to be evaluated stroke team. Right ICA was 100% closed but completely bypassed. She called four days later c/o redness and eye pain; at this point prominent iris vessels were seen, and she was sent to us. Her background history includes a diagnosis of moyamoya (underwent bilateral cerebral artery bypass 2015); atorvastatin for hypercholesterolemia; ASA; no hx of HTN or heart disease. She had a scleral buckle repair OD in 2017 and later developed a thick ERM, which was repaired in 2018; on her previous visit her acuity was noted at 20/40. On presentation her visual acuity was HM OD and 20/15 OS. IOP was 8 OD and 10 OS. There were prominent iris vessels in the right eye, no cell or flare, and an IOL. The posterior segment exam showed diffuse retinal whitening with attenuated vessels and boxcarring; there was sparing retinal whitening in a central area of the macula that appeared to be supplied by a cilio-retina artery. The FA showed very slow filling of the retinal vessels; there was some early perfusion secondary to the cilio-retinal artery. At 7 minutes there was still significant areas of non-perfusion, as well as macular ischemia. Avastin was administered, and one week later, PRP was performed. On the day PRP was performed, the irregular iris vessels had regressed completely. She said that she had a "sliver" of vision centrally in that eye; her acuity was CF 2' and IOP 12.

Photographer: Gretchen Harper

Imaging device: Topcon

Condition/keywords: central retinal artery occlusion (CRAO), cilioretinal sparing, moyamoya, neovascularization of iris (NVI)

Nov 17 2019 by John S. King, MD

60-year-old white female presented with five days of acute vision loss in the right eye. She was seen initially by referring doctor after hours five days ago and diagnosed with a CRAO and sent to ED to be evaluated stroke team. Right ICA was 100% closed but completely bypassed. She called four days later c/o redness and eye pain; at this point prominent iris vessels were seen, and she was sent to us. Her background history includes a diagnosis of moyamoya (underwent bilateral cerebral artery bypass 2015); atorvastatin for hypercholesterolemia; ASA; no hx of HTN or heart disease. She had a scleral buckle repair OD in 2017 and later developed a thick ERM, which was repaired in 2018; on her previous visit her acuity was noted at 20/40. On presentation her visual acuity was HM OD and 20/15 OS. IOP was 8 OD and 10 OS. There were prominent iris vessels in the right eye, no cell or flare, and an IOL. The posterior segment exam showed diffuse retinal whitening with attenuated vessels and boxcarring; there was sparing retinal whitening in a central area of the macula that appeared to be supplied by a cilio-retina artery. The FA showed very slow filling of the retinal vessels; there was some early perfusion secondary to the cilio-retinal artery. At 7 minutes there was still significant areas of non-perfusion, as well as macular ischemia. Avastin was administered, and one week later, PRP was performed. On the day PRP was performed, the irregular iris vessels had regressed completely. She said that she had a "sliver" of vision centrally in that eye; her acuity was CF 2' and IOP 12.

Photographer: Gretchen Harper

Imaging device: Topcon

Condition/keywords: central retinal artery occlusion (CRAO), cilioretinal sparing, moyamoya, neovascularization of iris (NVI)

Nov 17 2019 by John S. King, MD

60-year-old white female presented with five days of acute vision loss in the right eye. She was seen initially by referring doctor after hours five days ago and diagnosed with a CRAO and sent to ED to be evaluated stroke team. Right ICA was 100% closed but completely bypassed. She called four days later c/o redness and eye pain; at this point prominent iris vessels were seen, and she was sent to us. Her background history includes a diagnosis of Moyamoya (underwent bilateral cerebral artery bypass 2015); atorvastatin for hypercholesterolemia; ASA; no hx of HTN or heart disease. She had a scleral buckle repair OD in 2017 and later developed a thick ERM, which was repaired in 2018; on her previous visit her acuity was noted at 20/40. On presentation her visual acuity was HM OD and 20/15 OS. IOP was 8 OD and 10 OS. There were prominent iris vessels in the right eye, no cell or flare, and an IOL. The posterior segment exam showed diffuse retinal whitening with attenuated vessels and boxcarring; there was sparing retinal whitening in a central area of the macula that appeared to be supplied by a cilio-retina artery. The FA showed very slow filling of the retinal vessels; there was some early perfusion secondary to the cilio-retinal artery. At 7 minutes there was still significant areas of non-perfusion, as well as macular ischemia. Avastin was administered, and one week later, PRP was performed. On the day PRP was performed, the irregular iris vessels had regressed completely. She said that she had a "sliver" of vision centrally in that eye; her acuity was CF 2' and IOP 12.

Photographer: Gretchen Harper

Imaging device: Topcon

Condition/keywords: central retinal artery occlusion (CRAO), cilioretinal sparing, moyamoya, neovascularization of iris (NVI)

Nov 17 2019 by John S. King, MD

60-year-old white female presented with five days of acute vision loss in the right eye. She was seen initially by referring doctor after hours five days ago and diagnosed with a CRAO and sent to ED to be evaluated stroke team. Right ICA was 100% closed but completely bypassed. She called four days later c/o redness and eye pain; at this point prominent iris vessels were seen, and she was sent to us. Her background history includes a diagnosis of Moyamoya (underwent bilateral cerebral artery bypass 2015); atorvastatin for hypercholesterolemia; ASA; no hx of HTN or Heart Disease. She had a scleral buckle repair OD in 2017 and later developed a thick ERM, which was repaired in 2018; on her previous visit her acuity was noted at 20/40. On presentation her visual acuity was HM OD and 20/15 OS. IOP was 8 OD and 10 OS. There were prominent iris vessels in the right eye, no cell or flare, and an IOL. The posterior segment exam showed diffuse retinal whitening with attenuated vessels and boxcarring; there was sparing retinal whitening in a central area of the macula that appeared to be supplied by a cilio-retina artery. The FA showed very slow filling of the retinal vessels; there was some early perfusion secondary to the cilio-retinal artery. At 7 minutes there was still significant areas of non-perfusion, as well as macular ischemia. Avastin was administered, and one week later, PRP was performed. On the day PRP was performed, the irregular iris vessels had regressed completely. She said that she had a "sliver" of vision centrally in that eye; her acuity was CF 2' and IOP 12.

Photographer: Gretchen Harper

Imaging device: Topcon

Condition/keywords: central retinal artery occlusion (CRAO), cilioretinal sparing, moyamoya, neovascularization of iris (NVI)

Nov 5 2019 by Nichole Lewis

86-year-old male with progressive outer retinal necrosis, significant retinitis, retinal whitening, intraretinal hemorrhages and peripheral rpe changes. FA showed occlusive vasculitis with non-perfusion. Patient is immuno-suppressed with a history of renal transplant. VA 20/60.

Photographer: Nichole Lewis

Imaging device: Optos

Condition/keywords: intraretinal hemorrhage, occlusive vasculitis, progressive outer retinal necrosis (PORN), retinal pigment epithelium (RPE) changes, retinal whitening, retinitis

Sep 13 2019 by Patrícia José Figueiredo Lopes

A 19-year-old man presented in emergency department (ED) reporting painless blurred vision in the right eye that started one hour ago while he was doing exercise. His medical history was unremarkable. On examination, best corrected visual acuity in the right eye was counting fingers (20cm), right relative afferent pupillary defect was evident, intraocular pressure and anterior segment were normal. Dilated retinal examination revealed retinal whitening in the macular area and a cherry red spot (panel A) that became increasingly evident with time. Patient denied other systemic symptoms. Macular spectral domain optic coherence tomography showed hyperreflectivity of the inner retina (panel B). In ED, patient underwent ocular massage using a three-mirror contact lens and topical hypotensive treatment. Additionally, oral antiplatelet and hyperbaric oxygen treatment were initiated. Further investigation was performed and fluorescein angiography revealed a delay in arterial filling. Blood tests including hypercoagulation disorders investigation, plain chest radiography and electrocardiogram were unremarkable. Patent foramen ovale was diagnosed in transesophageal echocardiogram (panel C), anticoagulation therapy was promptly initiated and percutaneous closure of patent foramen ovale was done successfully a few weeks later. Final best corrected visual acuity was 20/200 and macula developed atrophy.

Photographer: Patrícia José

Condition/keywords: central retinal artery occlusion (CRAO), patent foramen ovale

Jun 1 2019 by John S. King, MD

84-year-old white female with acute loss of vision in the left eye one day ago was sent here after going to the ED per primary eye provider. She described vision loss as a grey curtain that became total darkness. She had left sided temporal tenderness and some left sided neck pain. In the ED the cardiac work-up was u/r, the ESR and CRP were normal, and the CTH showed some non-specific opacification in the L ethmoid sinus. Acuity was HM OS with RAPD, normal EOMs, no proptosis or ptosis, posteriorly no SVPs were noted; the optic discs were pink and flat; no emboli or retinal whitening present; some bear tracks located nasally (see photo). She was referred to Dr. Doyle, who ordered an MRI, which showed a large mucocele with bony erosion into the left orbit, along with some ON enhancement possibly from compression (see images). She was operated that night and later recovered to 20/40 in that eye with a residual, inferior arcuate scotoma.

Condition/keywords: bear tracks, optic neuropathy

Jun 1 2019 by John S. King, MD

84-year-old white female with acute loss of vision in the left eye one day ago was sent here after going to the ED per primary eye provider. She described vision loss as a grey curtain that became total darkness. She had left sided temporal tenderness and some left sided neck pain. In the ED the cardiac work-up was u/r, the ESR and CRP were normal, and the CTH showed some non-specific opacification in the L ethmoid sinus. Acuity was HM OS with RAPD, normal EOMs, no proptosis or ptosis, posteriorly no SVPs were noted; the optic discs were pink and flat; no emboli or retinal whitening present; some bear tracks located nasally (see photo). She was referred to Dr. Doyle, who ordered an MRI, which showed a large mucocele with bony erosion into the left orbit, along with some ON enhancement possibly from compression (see Images). She was operated that night and later recovered to 20/40 in that eye with a residual, inferior arcuate scotoma.

Condition/keywords: bear tracks, optic neuropathy

Jun 1 2019 by John S. King, MD

84-year-old white female with acute loss of vision in the left eye one day ago was sent here after going to the ED per primary eye provider. She described vision loss as a grey curtain that became total darkness. She had left sided temporal tenderness and some left sided neck pain. In the ED the cardiac work-up was u/r, the ESR and CRP were normal, and the CTH showed some non-specific opacification in the L ethmoid sinus. Acuity was HM OS with RAPD, normal EOMs, no proptosis or ptosis, posteriorly no SVPs were noted; the optic discs were pink and flat; no emboli or retinal whitening present; some bear tracks located nasally (see photo). She was referred to Dr. Doyle, who ordered an MRI, which showed a large mucocele with bony erosion into the left orbit, along with some ON enhancement possibly from compression (see images). She was operated that night and later recovered to 20/40 in that eye with a residual, inferior arcuate scotoma.

Photographer: Karin Aletter

Imaging device: Topcon 50

Condition/keywords: bear tracks, optic neuropathy

May 27 2019 by John S. King, MD

60-year-old African American female who had been treated for iridocyclitis for at least a week sent in for vitritis and a nasal fundus lesion. Complaints included redness, floaters, photophobia, and decreased vision. Husband had recent shingles. Acuity was 20/60-2 with IOP of 12, and small KP in Art's triangel, 1-2+ a/c cell, 2-3+ ant vit cell, diffuse arteriolar sheathing, multiple areas of retinal whitening in periphery and mid-periphery (see Photo #1). PCR of a/c was performed, and intravitreal GCV administered, and VACV 2g qid and ASA started.... PCR positive for HZV, pred taper was started two days after presentation as the infection had begun to stablize..... Five days from presentation the vision was 20/60, inflammation and areas of retinal whitening had improved (see Photo #2).... One week later acuity was 20/30, the a/c was quiet and KP resolved; ant vitreous cell decreased; and there was further improvement in retinal appearance without any signs of retinal holes or detachment; she is now on low dose maint VACV (see photo#3)

Photographer: Maysee Yang

Imaging device: Optos CA

Condition/keywords: acute retinal necrosis, Herpes zoster

May 27 2019 by John S. King, MD

60-year-old African American female who had been treated for iridocyclitis for at least a week sent in for vitritis and a nasal fundus lesion. Complaints included redness, floaters, photophobia, and decreased vision. Husband had recent shingles. Acuity was 20/60-2 with IOP of 12, and small KP in Art's triangel, 1-2+ a/c cell, 2-3+ ant vit cell, diffuse arteriolar sheathing, multiple areas of retinal whitening in periphery and mid-periphery (see Photo #1). PCR of a/c was performed, and intravitreal GCV administered, and VACV 2g qid and ASA started.... PCR positive for HZV, pred taper was started two days after presentation as the infection had begun to stablize..... Five days from presentation the vision was 20/60, inflammation and areas of retinal whitening had improved (see Photo #2).... One week later acuity was 20/30, the a/c was quiet and KP resolved; ant vitreous cell decreased; and there was further improvement in retinal appearance without any signs of retinal holes or detachment; she is now on low dose maint VACV (see photo#3)

Photographer: Maysee Yang

Imaging device: Optos CA

Condition/keywords: acute retinal necrosis, Herpes zoster

May 27 2019 by John S. King, MD

60-year-old African American female who had been treated for iridocyclitis for at least a week sent in for vitritis and a nasal fundus lesion. Complaints included redness, floaters, photophobia, and decreased vision. Husband had recent shingles. Acuity was 20/60-2 with IOP of 12, and small KP in Art's triangel, 1-2+ a/c cell, 2-3+ ant vit cell, diffuse arteriolar sheathing, multiple areas of retinal whitening in periphery and mid-periphery (see Photo #1). PCR of a/c was performed, and intravitreal GCV administered, and VACV 2g qid and ASA started.... PCR positive for HZV, pred taper was started two days after presentation as the infection had begun to stablize..... Five days from presentation the vision was 20/60, inflammation and areas of retinal whitening had improved (see Photo #2).... One week later acuity was 20/30, the a/c was quiet and KP resolved; ant vitreous cell decreased; and there was further improvement in retinal appearance without any signs of retinal holes or detachment; she is now on low dose maint VACV (see photo#3)

Photographer: Maysee Yang

Imaging device: Optos CA

Condition/keywords: acute retinal necrosis, Herpes zoster

Apr 8 2019 by Gary R. Cook, MD, FACS

39-year-old white female with geographic area of retinal whitening ( Berlin's edema) without hemorrhage in the midperiphery secondary to blunt trauma; V.A. = 20/25

Imaging device: Topcon VT-50

Condition/keywords: Berlin's edema, blunt trauma, retinal edema

Mar 27 2019 by Gary R. Cook, MD, FACS

Right eye of a 56-year-old white male with a combined perfused CRVO (venous dilation and dot & blot hemorrhages in all 4 quadrants) and a superotemporal BRAO with peripapillary hemorrhages and cotton wool spots, and an area of retinal whitening inside of the ST arcade. V.A.= 20/70.

Imaging device: Topcon VT-50

Condition/keywords: branch retinal artery occlusion (BRAO), central retinal vein occlusion (CRVO)