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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:
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Retina
Case 29
Patient Presentation: A 35 year old healthy female presented to the eye clinic with decreased vision in her left eye x 3 days. Her past ocular history was significant for myopia. She denied any recent ocular trauma.
On examination, vision was 20/20 in the right eye and 20/60 in the left eye. There was no relative afferent pupillary defect and she had normal intraocular pressures. Slit lamp examination was normal. Dilated fundus examination demonstrated peri-papillary atrophy and tilted nerves in both eyes. An OCT macula was performed in both eyes, shown below:
Question: Which of the following material does NOT appear hyper-reflective on OCT?
Question: Please describe the OCT of the left eye:
Question: Based on the clinical presentation and the OCT, what is the most likely diagnosis?
Question: Which of the following can be used in the treatment of mCNVM?
The patient in our case was treated with intravitreal anti-VEGF agent, and a repeat OCT was performed one month later, shown to the left. Notice that the sub-retinal hyper-reflective lesion has shrunken in size after treatment.
Learning Objectives:
1. To review the OCT features of myopic CNVM
2. To understand the OCT parameters in evaluating mCNVM activity
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