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 5

Patient Presentation: A 11-year-old aphakic male with a history of microspherophakia s/p cataract surgery presents to an emergency room with decreased vision in the left eye x 3 months. BCVA was 20/40 OD and 20/100 OS. His pupils remained meiotic despite multiple attempts to dilate his pupils pharmacologically. The view to the fundus was poor. An OCT macula was performed demonstrating the following:

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Question: What abnormalities do you visualize in the patient's OCT image?

A. Intra-retinal Cysts

B. Detached Neurosensory Retina

C. Vitreous Cells

D. All of the Above

What is the Diagnosis?

Click Here for Case Diagnosis

An OCT was also performed on the contralateral right eye demonstrating the following:

Retina Case 5-2

Question: What is the diagnosis?

A. Retinoschisis

B. Optic Pit Maculopathy

C. Retinal Detachment

D. Branch Retinal Artery Occlusion

Question: What layer of the retina is the yellow arrow pointing to?

A. Ellipsoid Zone

B. External Limiting Membrane

C. Retinal Nerve Fibre Layer

D. Retinal Pigment Epithelium

Learning Objectives:

1) Diagnose a retinal detachment on OCT and identify the difference between a macula on and off retinal detachment.

2) Recognize that OCT can be useful in cases where there is a sub-optimal view of the macula.