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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 87
Patient presentation: An 83-year-old male was referred to a tertiary retina clinic for a 2-week history of visual distortion in his right eye. He reported noticing an oval shape in his central visual field OD. He denied pain, GCA symptoms, flashes, floaters, or trauma. His past ocular history included cataract surgery OU. He was a non-smoker.
His best-corrected distance visual acuity was 20/25 OD and 20/20 OS. There was no RAPD. Anterior segment examination was within normal limits. Fundus examination revealed a blunted foveal reflex OD, but was otherwise unremarkable OU.
OCT macula images were taken and are shown below:
Question 1: What are the most striking features on the OCT images above?
IVFA images of the right eye, early (left) and late (right), were taken and are shown below:
Question 2: What finding is present in the IVFA images above?
Question 3: Based on the OCT and IVFA images, what is the most likely diagnosis?
Question 4: What is unique about this lesion compared to other lesions in its class?
Learning Objectives:
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Recognize the clinical, OCT, and IVFA features of a RAP lesion (type 3 CNVM).
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