Contributor: Eli Kisilevsky MD
Patient Presentation: A 26 year-old previously healthy female presented to ophthalmology clinic with a 3 day history of a central scotoma in the left eye. She endorsed influenza-like symptoms one week prior to presentation. She denied history of sun-gazing. Her review of symptoms was otherwise unremarkable. Uncorrected visual acuity was 20/20 and 20/30 with normal pupils and IOP. Slit lamp examination was unremarkable with no evidence of anterior chamber inflammation. Dilated fundus examination revealed the following:
Question: Describe the image
An OCT of the macula was performed to further evaluate the abnormality:
Question: Based on the fundus images, which of the following is on your differential?
Question: What layer of the retina is disrupted in the OCT of the left eye?
Intravenous fluorescein angiogram was then performed:
Question: Describe this image
Question: Based on the history, examination, and imaging findings, what is the most likely diagnosis?
Question: What would you do next?
The patient was observed:
Follow-up OCT (1 month later)
Follow-up OCT (2 months later)
Serial OCT examination demonstrating resolution of the dome shaped lesion but some irregularity of the interdigitation zone remained. Vision improved to 20/20 at last follow up.
1. Describe findings of ARPE on OCT
2. Differentiate ARPE from other idiopathic maculopathies based on OCT and IVFA.