Case 7

Patient Presentation: A 21-year-old male was seen in clinic for progressive decline in vision and worsening photophobia OU. Visual acuity was 20/30 OD and 20/30 OS. Colour vision was 5/16 Ishihara plates in both eyes. Fundus photos are shown below:

Given the decline in vision, an OCT macula was performed below:

Describe the OCT

Question: The yellow arrow is pointing towards the most anterior hyper-reflective line in the outer retina. What layer of the retina is it pointing to?

Question: What investigation should be performed next?

Learning Objectives:

1. Identify OCT features in cone dystrophy.

2. Recognize the external limiting membrane on OCT.

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