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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 21

Patient Presentation: A 63-year-old male presented to the ophthalmology office with a 2 month history of decreased vision in his left eye. On examination, his vision is CF in the left eye. Slit lamp examination was normal. Dilated fundus examination revealed the diagnosis. An OCT macula was performed revealing the following:

Question: Based on the OCT, what is the diagnosis?

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A. Macular hole

B. Retinal detachment

C. Retinal edema

D. All of the above

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Question: What features on this OCT scan indicate that this is likely a chronic process?

A. Smooth outer retinal layers

B. Intra-retinal cysts

C. Vitreous inflammation

D. All of the above

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Question: Surgery was performed. Post-operatively, his visual acuity was 20/200. The OCT below demonstrates the post-operative appearance of the retina. Based on the OCT, what are some potential visual prognostic findings?

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Learning Objectives:

1. List OCT features that correlate with poor visual outcomes post-retinal detachment repair

2. Recognize macular hole as a cause of a rhegmatogenous retinal detachment

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