Patient Presentation: A 23-year-old obese female was diagnosed with idiopathic intracranial hypertension (IIH) and referred to neurosurgery for ventriculoperitoneal shunt. A baseline ocular examination was performed prior to the procedure.

On examination, vision was 20/200 in the right eye, and 20/40 in the left eye. There was a right relative afferent pupillary defect. Slit lamp examination was normal.

A dilated fundus examination was performed demonstrating the following:

OCTcases (logo1).png

Retina

Case 20

Patient Presentation: A 73-year-old female presents to ophthalmology clinic for a routine follow-up appointment. Her vision is 20/20 in the right eye and 20/400 in the left eye. Her central vision in the left eye has been poor for many years. An OCT macula was performed in the left eye demonstrating the following:

Question: Please describe this OCT?

Click Here For Answer

Retina 20-1.png

Retina 20-3.png

Question: Why does choroidal hyper-transmission occur?

A. Hyper-reflective deposits in the choroid

B. Migration of the RPE into the choroid

C. Increased OCT signal penetration

D. None of the above

Question: What is the likely diagnosis?

A. Geographic atrophy

B. Vitelliform macular dystrophy

C. Choroidal neovascular membrane

D. Vitreomacular adhesion

Learning Objectives:

1. Identify OCT features of geographic atrophy

2. Understand why choroidal transmission occurs in geographic atrophy