Contributors: Marko Tien (Medical Student) and Dr. Amrit Rai
Patient Presentation: An 11-year-old male was referred to ophthalmology for an abnormal retinal lesion in the left eye. The patient is asymptomatic. Visual fields are normal, and BCVA is 20/20 OU. Fundus exam was performed and is shown below:
Question: Where is the lesion in this eye?
OCT was performed over the lesion and shown below.
Question: What is the abnormality seen in the OCT?
Question: Based on the imaging and exam findings, what is the most likely diagnosis?
Question: What is the prognosis of a patient who presents with dark-without-pressure lesions?
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Flores Pimentel, M.A., Duncan, J.L., de Alba Campomanes, A.G. et al. (2021). Dark without pressure retinal changes in a paediatric age group. Eye 35, 1221–1227. https://doi.org/10.1038/s41433-020-1088-5
Gupta, Gaurav & Bajgai, Priya & Singh, Ramandeep. (2018). Dark-Without-Pressure Fundus Lesions.
Nagpal, K. C., Goldberg, M. F., Asdourian, G., Goldbaum, M., & Huamonte, F. (1975). Dark-without-pressure fundus lesions. The British journal of ophthalmology, 59(9), 476–479. https://doi.org/10.1136/bjo.59.9.476
Rafieetary, M. (Feb 2021). Navigating the Retinal Periphery. Review of optometry (eJournal). Accessed on Nov 12, 2021: https://www.reviewofoptometry.com/article/navigating-the-retinal-periphery
Strohbehn A. Sohn EH. Retinal Detachment: From One Medical Student to Another. EyeRounds.org. October 15, 2013; available from http://EyeRounds.org/tutorials/retinal-detachment-med-students
Identify the funduscopic presentation and OCT findings of dark-without-pressure lesions.
Understand the clinical significance and prognosis of dark-without-pressure lesions