Case 40

Patient Presentation: A 34-year-old presents to the emergency department after waking up this morning with blurred vision and floaters OS. On exam, visual acuity is 20/20 OD, 20/60 OS. There is no indirect ophthalmoscope available in the emergency room, but there is surprisingly an OCT machine at your disposal. OCT macula OS is shown below:

Retina 40-1.png

Question: Is this an OCT image of the right or left eye?

Question: What abnormal findings are seen on OCT?

Question: On further history, the patient is a type 1 diabetic with poor control of his blood sugar levels. Given this information, what do the hyper-reflective dots in the vitreous likely represent?

Learning Objectives:

1. To diagnose and recognize vitreous hemorrhage on OCT