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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:
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Retina
Case 69
Contributor: Shaan Bhambra MD, Wei Wei Lee MD FRCSC
Patient Presentation: A 62-year old male presented to the emergency room after experiencing flashes and floaters for a week OD. He denied past medical or ocular history, though he did note a glasses prescription of -5.50D OU. His vision was 20/200 OD and 20/25 OS. IOP was 11 OD and 14 OS; there was no RAPD. Anterior segment examination was within normal limits, though the vitreous was Shafer's sign positive OD. Fundus examination demonstrated a macula-off rhegmatogenous retinal detachment (RRD) extending from 11 to 3 o'clock with a single retinal tear at 12 o'clock OD.
Question 1: What is the preferred treatment method for a superior rhegmatogenous retinal detachment (RRD) with all breaks able to be visualized?
The patient returned to clinic 1 month following his PnR. He denied any flashes or field defect, but did note a few persistent floaters OD. His vision was 20/30 OD. An en face OCT was conducted and shown below:
Question 2: What are the red arrows in the above en face OCT demonstrating?
Question 3: Which RRD repair method is more highly correlated with the development of ORFs?
Question 4: How are ORFs associated to post-operative visual acuity?
Learning Objectives:
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Understand how to diagnose ORFs on OCT imaging.
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The significance and prevalence of ORFs after RRD surgery.
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