Case 11

Patient Presentation: A 27-year-old female presented to the ophthalmology clinic with a 1-week history of decreased vision in the left eye. She had a history of renal transplantation and was on immunosuppressive medications. Her most recent blood work demonstrated anemia and thrombocytopenia. She denied history of trauma. On examination, vision was 20/20 OD and 20/150 OS. Pupils were equal and reactive to light. Fundus photograph and OCT macula are shown below:



Retina 11-1.png
Retina 11-2.png

Question: The fundus photograph demonstrates a macular hemorrhage in the left eye. What layer of the retina is the hemorrhage situated in?

Retina 11-3.png
Retina 11-1.png

Question: The red arrow is pointing to an arrow of hypo-reflectivity underneath the hemorrhage. What does this represent?

Question: Of the following choices, which can cause sub-ILM hemorrhages?

Learning Objectives:

1. Recognize that OCT can provide valuable information regarding the location of retinal pathology.

2. Identify the inner limiting membrane on OCT.