top of page
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:
.png)
Uveitis
Case 18
Patient Presentation: A 60-year-old woman with past medical history of hypothyroidism presented with 4 weeks of painless blurred vision in her right eye. She denied eye pain, headache, URI or systemic symptoms. She had no pets and no history of TB exposure. On exam, visual acuity was 20/150 OD and 20/20 OS. There was no lymphadenopathy and her blood pressure was normal. Fundus photographs are shown below.
OCT macula images were taken and are shown below:
Question 1: Which of the following best explains the findings on OCT in the right eye?
Question 2: What is the diagnosis?
Question 3: What is included in the differential diagnosis for macular star and optic disc edema?
The patient underwent a standard uveitic panel. CBC, Lytes, Creatinine, angiotensin converting enzyme (ACE), syphilis serology, ANA, TB quantiferon gold, and Bartonella serology were negative. The patient was diagnosed with idiopathic neuroretinitis.
Question 4: How should the patient be managed?
Question 5: What percentage of non-recurrent idiopathic neuroretinitis cases reach 20/40 or better?
References:
-
Purvin V, Sundaram S, Kawasaki A. Neuroretinitis: review of the literature and new observations. J Neuroophthalmol. 2011 Mar;31(1):58-68. doi: 10.1097/WNO.0b013e31820cf78a. PMID: 21317731
Learning Objectives:
-
Understanding the typical presentation and clinical course of neuroretinitis.
-
Learn the typical features on OCT of neuroretinitis.
bottom of page