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 56
Contributor: Marko Tien (University of British Columbia Medical Student)
Patient Presentation: A 67-year-old woman was referred to ophthalmology for AMD screening. She has no ocular complaints. No other neurological symptoms. She has a history of hypertension and hypercholesterolemia, for which she is taking medications for. On presentation, visual acuity was 20/25 OU.
Question: OCT 5 line raster was done and shown above. Between which layers is an abnormality seen?
Question: Fundus photography and autofluorescence were taken and shown above. What is the primary abnormality seen in the set of photos?
Question: Based on the findings, what is the most likely diagnosis?
Question: How does a reticular pseudodrusen differ from a typical drusen?
Question: How does the prognosis of reticular pseudodrusen differ from typical drusen? Reticular pseudodrusens are ______
References:
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Chan, H., Cougnard-Grégoire, A., Delyfer, M. N., Combillet, F., Rougier, M. B., Schweitzer, C., Dartigues, J. F., Korobelnik, J. F., & Delcourt, C. (2016). Multimodal Imaging of Reticular Pseudodrusen in a Population-Based Setting: The Alienor Study. Investigative ophthalmology & visual science, 57(7), 3058–3065. https://doi.org/10.1167/iovs.16-19487
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De Bats, F., Wolff, B., Mauget-Faÿsse, M., Meunier, I., Denis, P., & Kodjikian, L. (2013). Association of reticular pseudodrusen and early onset drusen. ISRN ophthalmology, 2013, 273085. https://doi.org/10.1155/2013/273085
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Rabiolo, A., Sacconi, R., Cicinelli, M. V., Querques, L., Bandello, F., & Querques, G. (2017). Spotlight on reticular pseudodrusen. Clinical ophthalmology (Auckland, N.Z.), 11, 1707–1718. https://doi.org/10.2147/OPTH.S130165
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Wightman, A. J., & Guymer, R. H. (2019). Reticular pseudodrusen: current understanding. Clinical & experimental optometry, 102(5), 455–462. https://doi.org/10.1111/cxo.12842
Learning Objectives:
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To identify reticular pseudodrusen on OCT and fundus photos
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To understand how reticular pseudodrusens differ from typical drusens
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To understand the prognostic value and association of reticular pseudodrusens with late AMD