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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 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

Jun 30 2025 by Maria Letícia Costa Holanda

Fundoscopy of a 42-year-old asymptomatic man with pigmented paravenous chorioretinal atrophy. Pigmented paravenous retinochoroidal atrophy (PPRCA) is a rare disorder of unknown etiology. The disease is characterized by pigment accumulation along the distribution of retinal veins. The findings are usually incidental with minimal effect on vision.

Photographer: Guilherme da Cruz Reis, CLINOS Eye Hospital - Feira de Santana (BA),Brazil

Condition/keywords: pigmented paravenous chorioretinal atrophy (PPCRA)

Jun 27 2025 by Maria Letícia Costa Holanda

Fundoscopy of a 42-year-old asymptomatic man with pigmented paravenous chorioretinal atrophy. Pigmented paravenous retinochoroidal atrophy (PPRCA) is a rare disorder of unknown etiology. The disease is characterized by pigment accumulation along the distribution of retinal veins. The findings are usually incidental with minimal effect on vision.

Photographer: Guilherme da Cruz Reis, CLINOS Eye Hospital - Feira de Santana (BA),Brazil

Condition/keywords: pigmented paravenous chorioretinal atrophy (PPCRA)

Jun 27 2025 by Maria Letícia Costa Holanda

Fundoscopy of a 42-year-old asymptomatic man with pigmented paravenous chorioretinal atrophy. Pigmented paravenous retinochoroidal atrophy (PPRCA) is a rare disorder of unknown etiology. The disease is characterized by pigment accumulation along the distribution of retinal veins. The findings are usually incidental with minimal effect on vision.

Photographer: Guilherme da Cruz Reis, CLINOS Eye Hospital - Feira de Santana (BA),Brazil

Condition/keywords: pigmented paravenous chorioretinal atrophy (PPCRA)

Jan 20 2021 by Niloofar Piri, MD

Prepapillary congenital vascular loop in an asymptomatic patient.

Photographer: Lisa Breeding, Saint Louis University

Condition/keywords: vascular loop, venous loop

Jan 25 2022 by Kachelle Brown

Ultra-wide field photograph of a 48-year-old female with a prominent long ciliary nerve. Patient presented asymptomatic, and was referred for a macula on retinal detachment. Patient was diagnosed with high myopia and a posterior vitreous detachment, and the physician discussed increased risk of floaters, myopic degeneration and retinal detachment associated with high myopia. -24.00 prior to cataract surgery OU per patient.

Photographer: Kachelle Brown

Imaging device: Optos California

Condition/keywords: fundus photograph, high myopia, long ciliary nerve, optos, right eye, ultra-widefield image

May 18 2020 by McGill University Health Centre

Choroidal melanoma is often asymptomatic and diagnosis is incidental. The tumors may grow beneath the retina, or may break through the Bruch membrane and disrupt the retina. Tumors breaking through the Bruch membrane and disrupting the retina have a characteristic “mushroom” shape. This enucleation specimen demonstrates a section of a choroidal melanoma showing an intraocular tumor with an extraocular extension (arrow).

Condition/keywords: extraocular extension

May 18 2020 by McGill University Health Centre

Choroidal melanoma is often asymptomatic and diagnosis is incidental. The tumors may grow beneath the retina, or may break through the Bruch membrane and disrupt the retina. Tumors breaking through the Bruch membrane and disrupting the retina have a characteristic “mushroom” shape. The enucleation specimen in (A) shows a whitish, nodular choroidal tumor at the posterior pole (*). Note the retinal detachment overlying the tumor.

Condition/keywords: choroidal tumor

Mar 5 2015 by Andrew M Hendrick, MD

Fundus photograph of an asymptomatic 54-year-old male with a history of HIV and chronic DDI use.

Photographer: Matt Raeber, Emory University

Condition/keywords: drug toxicity

Sep 6 2021 by Ricardo Leitão Guerra

65-year-old woman with an asymptomatic ERM (BCVA=20/20).

Imaging device: Zeiss Clarus 700

Condition/keywords: epiretinal membrane (ERM)

Nov 29 2023 by Virginia Gebhart

74 year-old female with presumed fibrotic granuloma. Previously diagnosed as pseudoduplication of the optic disc by general ophthalmologist. OCT showed elevation in the RPE, more consistent with granuloma. Pt has been aware for many years, asymptomatic. Will observe.

Photographer: Virginia Gebhart

Imaging device: Topcon 50DX

Condition/keywords: fibrotic scar, granuloma, Pseudoduplication of optic disc

Sep 16 2017 by Purva Patwari

Asymptomatic horse shoe tear found on preoperative cataract assessment of a 54-year-old male patient. Laser barrage was done and he underwent Phacoemulsification surgery a month later.

Photographer: Dr Purva Patwari,Patwari Retina Center,Ahmedabad,India

Imaging device: Zeiss Visucam 500

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

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)

Apr 24 2022 by Aniruddha K Agarwal, MD

Ultra-wide field fundus fluorescein angiography (FFA) of the left eye from an asymptomatic, healthy 33-year-old woman who was referred to the retina clinic from a refractive surgery unit due to the presence of vascular anomalies and hard exudates in both eyes. FFA revealed the characteristic sacular aneurysms at the bifurcation of retinal arterioles in the posterior pole, together with microvascular anomalies and capillary closure peripherally.

Photographer: Julio J GONZALEZ-LOPEZ, MD, PhD, FEBO and Teresa GONZALEZ-LOMAS, RN

Imaging device: Optos California

Condition/keywords: IRVAN Syndrome, IUSG, neuroretinitis, retinal vasculitis, uveitis

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

May 31 2023 by Aditya S Kelkar, MS, FRCS, FASRS,FRCOphth

Importance of dilated retina check up before Lasik surgery can't be better demonstrated...patient totally asymptomatic came for Lasik opinion and has inferior retinal detachment with lattice and holes, sparing the macula

Photographer: Dr. Sahil Wagh , National Institute of Opthalmology, Pune , India

Imaging device: Zeiss Clarus 500

Condition/keywords: inferior retinal detachment

Mar 11 2022 by Bryon R McKay, MD, PhD, FRCSC, DRCPSC - Retina

Optos widefield fundus photograph and IVFA of a 23-year-old female with asymptomatic isolated retinal capillary hemangioblastoma without exudation. IVFA demonstrates some mild late leakage. The tumor measures 1.5mm and was effectively ablated with laser photocoagulation.

Imaging device: Optos

Condition/keywords: retina capillary hemangioblastoma

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

Jan 16 2018 by Carolyn Daley

58-year-old woman with an operculated hole and CHRPE in the right eye. Patient is asymptomatic so no treatment was recommended at this time.

Photographer: Carolyn Daley

Imaging device: Optos ultra wide field image

Condition/keywords: congenital hypertrophy of the retinal pigment epithelium (CHRPE), operculated retinal hole, Optos, ultra-wide field imaging

Nov 8 2021 by Michael Grinton

Optic disc pits are rare congenital abnormalities of the optic nerve head. Colour fundus image of an asymptomatic 18-year old male shows an optic disc pit in the right eye (A, white arrow); a small, grey, oval shaped excavation in the temporal segment of the optic disc. These pits are usually unilateral (B shows normal colour fundus of left eye) and asymptomatic. Imaging with optical coherence tomography (C) shows the optic disc pit in cross section (white arrow) and normal macular structure. In some patients with the condition, fluid can accumulate underneath the macular (serous macular detachment).

Condition/keywords: Optic disc pit, Optic nerve pit, Optic pit

Feb 12 2015 by Timothy S Fuller, MD

Fundus autofluorescence image of a 34-year-old woman with striking, asymptomatic optic nerve head drusen.

Photographer: Nice Hesse, Texas Retina Associates

Imaging device: Heidelberg Spectralis

Condition/keywords: drusen of optic disc

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

Jun 2 2020 by Dhaivat Shah

Peri-papillary vascular loops (PVL) are rare congenital vascular malformations, which are usually detected as accidental finding during routine fundus examination. They can often be confused with tributary vein occlusion or racemose hemangioma. Although benign and asymptomatic, they can be rarely associated with vitreous hemorrhage and arterial occlusion. We herein present a case of a 60-year-old hypertensive male, who was diagnosed elsewhere to have a tributary vein occlusion and was referred to us. FFA was advised to rule out neovascularization, surrounding capillary non perfusion and mass lesion (hemangioma). On FFA, the arterial loop showed a slightly delayed filling (3-5 seconds) as compared to the other arterial vessels and the original vessel appeared to be a branch arising from central retinal artery. The choroidal filling was delayed in the area supplied by the loop. A cilioretinal artery was also noted. The patient was diagnosed to have a Peri-papillary vascular arterial loop (PVL), likely to be congenital in origin. The patient was reassured and was advised yearly follow up. These loops are usually accidental findings discovered during routine fundus examination. Since these vessels are looped and tortuous, they exhibit a slower and laminar blood flow, which make them more prone for arterial occlusions. The vitreous in this area tends to be adherently attached, so during PVD induction, it is likely to cause a tear and hemorrhage leading to vitreous hemorrhage. Until and unless there is a break, this hemorrhage tends to resolve on its own and does not warrant treatment. If there is an evident break, it can be dealt with laser barrage.

Photographer: Choithram Netralaya

Condition/keywords: congenital prepapillary vascular loop