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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 33
Patient Presentation: A 56-year-old male presented to the eye clinic with acute onset of metamorphopsia x 3 days in the left eye. His past ocular history is significant for myopia. He was seen 7 months prior in eye clinic and had a stable eye examination. On examination today, his vision was 20/200 in the left eye compared to 20/60 at his last eye examination 7 months prior. There was no RAPD. His slit lamp examination demonstrated mild nuclear sclerosis. Fundus examination demonstrated a myopic fundus with no obvious new changes in the macula. An OCT macula was performed today and compared with the OCT seven months ago.
HD 5 Line Raster: Today
HD 5 Line Raster: 7 Months Ago
Question: Based on the serial OCT scans shown, what is the most noticeable change between the scans?
Question: The macula of the left eye is seen below in the SLO image (A) with the corresponding horizontal OCT section (B). What does the image below highlight?
Question: Given the acute change in vision, what investigation should be performed next?
Question: While scrolling through the scans in the macular cube protocol, the following OCT image (left) is seen. What is the diagnosis?
Recall that in contrast to a macular pseudohole, a FTMH involves the full thickness of the retina.
Learning Objectives:
1. Review the OCT findings seen in a posterior staphyloma
2. Understand the shortcomings of the raster protocol
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