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 35

Patient Presentation: A 77-year-old female presented for her 1-month follow-up following left eye pneumatic retinopexy treatment for retinal detachment. Although her retina appears re-attached on fundus examination, she reports that her vision remains distorted. Her vision was 20/20 OD and 20/30 OS. Her OS Optos wide-field image and OCT macula is shown below:

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Question: What abnormality is seen on the OCT above?

A. Intra-retinal cysts

B. Subretinal fluid

C. Disorganization of inner retinal layers

D. Epiretinal membrane

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Question: The patient returned 6-months later following her pneumatic retinopexy surgery. The patient noted no improvement in her vision and continued to endorse blurriness OS. Her vision remained 20/20 OD and 20/30 OS. Her OS OCT is shown below. What abnormality is shown in the OCT?

A. Intra-retinal cysts

B. Subretinal fluid

C. Disorganization of inner retinal layers

D. Epiretinal membrane

Learning Objectives:

1. Recognize persistent sub-retinal fluid as a potential complication in retinal detachment repair

2. Appreciate the brush-border appearance to occur in the setting of chronic subretinal fluid