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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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Paediatric Ophthalmology
Case 6
Patient Presentation: A 12-year-old female was referred by her optometrist to a paediatric retina clinic for painless decreased vision over the last 2 months. The patient denied any past medical history or family history of eye diseases; the parents were first cousins. She denied any trauma, red eye or visual field deficit. Visual acuity was 20/30 OD and 20/40 OS. IOP was 13mmHg OD and 14mmHg OS; there was no RAPD. Fundus photographs and OCT macula images were taken and are shown below:
Question 1: What is the main finding of the OCT macula images above?
Question 2: Based on the patient history, fundus photos, and OCT images, what is the most likely diagnosis?
Question 3: What is the most common gene implicated in CACD?
One-year later, the patient presented with further decreased vision in the right eye. Visual acuity was 20/60 OD and 20/40 OS. Fundus photos and OCT macula images were taken and are shown below:
Question 4: Describe the OCT images above
To characterize the changes seen on fundus photography and OCT imaging, an OCT angiography was taken and confirmed a new choroidal neovascular membrane OD:
Question 5: What is the best treatment for this patient's new CNVM?
Learning Objectives:
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Understand the OCT findings in central areolar choroidal dystrophy.
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Appreciate the possible complications of CACD
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