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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 70
Patient Presentation: A 45-year-old female patient presented to a tertiary ophthalmology centre with a 2-day history of painless blurred vision in her right eye. BCVA was 20/200 OD and 20/40 OS. IOP was 15 OU. OCT macula OU was performed and is shown below:
Question 1: What layers of the neurosensory retina are split on the OCT macula image OD?
Question 2: What additional finding is seen on OCT macula OD?
Question 3: What is the unifying diagnostic abnormality on OCT?
Question 4: What is the most common cause of BALAD?
References:
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Ramtohul P, Engelbert M, Malclès A, et al. Bacillary layer detachment: multimodal imaging and histologic evidence of a novel optical coherence tomography terminology: Literature reviewi and proposed theory. Retina. 2021 Nov 1;41(11):2193-2207.
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Cicinelli MV, Giuffré C, Marchese A, et al. The bacillary detachment in posterior segment ocular diseases. Ophthalmol Retina. 2020;4:454–456.
Learning Objectives:
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To understand the features of bacillary retinal detachment using OCT findings.
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To understand the underlying etiologies causing bacillary retinal detachment and the diagnostic workup involved in these cases.
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