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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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Ocular Oncology
Case 5
Patient Presentation: A 74-year-old male was referred to an ocular oncology clinic for assessment of a suspicious pigmented choroidal lesion OS found on a routine eye examination. The patient denied any past medical or ocular history. He denied change in vision or visual symptoms. His vision was 20/25 OD and 20/20 OS with pressures within normal limits. Anterior segment examination was unremarkable. Fundus photos OS were performed and are shown below:
Question: What additional finding is appreciated on the OS fundus photos?
A 5-line raster OCT was conducted over the lesion in question, and is shown below:
Question: What is the most likely diagnosis?
When examining the OCT macula, you note that there was suspicious sub-RPE hyper-reflective material, shown by the red arrow below.
This fibrovascular PED was further characterized by an OCT angiography, which is shown below:
Question: What complication of choroidal nevi is demonstrated by the OCTA?
Question: What treatment would be used to manage the CNV associated with the choroidal nevus?
Learning Objectives:
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Features favouring a diagnosis of a choroidal nevus in comparison to choroidal melanoma
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Diagnosis and treatment of CNV complication of choroidal nevus
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