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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:
Retina
Case 65
Contributor: Shaan Bhambra (McGill University Medical Student)
Patient Presentation: A 41-year-old male presented to a tertiary retina clinic complaining of “wavy” vision OD for 1 month. His past medical history was significant for hyperlipidemia and diet-controlled T2DM. His only medication was rosuvastatin. He notes new stress at home and work over the last 3 months.
Slit lamp examination was within normal limits. Fundus photos were taken and can be seen below:
![r65_1.png](https://static.wixstatic.com/media/699564_b91eab7c75f24d24a2a79933ed7b79ff~mv2.png/v1/fill/w_323,h_308,al_c,lg_1,q_85,enc_auto/r65_1.png)
![r65_2.png](https://static.wixstatic.com/media/699564_658d383be9864a769bda062bcbf1f44b~mv2.png/v1/fill/w_325,h_308,al_c,lg_1,q_85,enc_auto/r65_2.png)
OCTs of the macula were taken and are shown below:
![r65_3.png](https://static.wixstatic.com/media/699564_79ad8175866e480dbd5a653f4ea2b8a5~mv2.png/v1/fill/w_447,h_220,al_c,q_85,usm_0.66_1.00_0.01,enc_auto/r65_3.png)
![r65_4.png](https://static.wixstatic.com/media/699564_7d12cee46de749be9f40dedd23f20182~mv2.png/v1/crop/x_0,y_0,w_512,h_239/fill/w_475,h_220,al_c,q_85,usm_0.66_1.00_0.01,enc_auto/r65_4.png)
Question: Based on the OCTs above, what is the most likely diagnosis?
Question: Which type of OCT allows for the best visualisation of the choroid?
Question: Which is the most effective treatment for this diagnosis at this time?
Learning Objectives:
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OCT identification and treatment of acute CSR
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Treatment and management of acute CSR
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Risk factors and pathophysiology of CSR
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