Retinal Assistant Module Blog

Caused by an epiretinal membrane, clinically, it appears as a sheen abnormal foveal reflex which features epiretinal membrane, due to inflammatory mediators and proliferation of glial cells secondary to a partial separation of posterior cortical vitreous. Fundus image shows cellophane maculopathy OCT features a hyperreflective band covering the inner retinal layers, causing minimal disturbance of inner retinal tissues. OCT cross-section shows epiretinal membrane  Cellophane maculopathy itself in individuals with good visual acuity may not need any interventions, but it is warranted to do a detailed peripheral retinal exam to rule out retinal tear or hole However, an epiretinal membrane may proliferate further and cause additional tangential traction. Thus, it may induce macular pucker or lamellar/pseudo hole and increase disturbance of inner retinal tissues, macular thickness, and reduction of vision. These patients may require pars plana vitrectomy to remove the epiretinal membran...

One of the most common pattern dystrophies similar to best occurs in adulthood, as it appears as oval or yellowish macular material, originated from the debris of photoreceptors, or the RPE phagocytosis failure. Fundus image showing Adult-onset vitelliform macular dystrophy  On OCT, it appears as subretinal vitelliform material accumulation but above the RPE with intact ellipsoid zone and thus explains good visual acuity without an increase in retinal thickness. OCT cross-section showing Adult-onset vitelliform macular dystrophy Fluorescein angiography typically shows hypo-fluorescence at the area of vitelliform accumulation surrounded with hyper-fluorescence increases intensity in late phases; however, it may show liner, patchy, or ring-like, which is inconsistent with visual acuity. Adult-onset vitelliform macular dystrophy itself does not warrant any treatment; however, a regular follow up to monitor any progression to choroidal neovascularization. How would you approa...

A fifty-five-year-old female complained of onset reduction of vision one week ago in his left eye to 20/80 with no medical history. Fundus Image The fundus image shows flamed shaped hemorrhage with cotton wool spots covering the superior temporal arcade with macular involvement. Fundus image showing branch retinal vein occlusion  Optical coherence tomography OCT vertical scan shows hyperreflectivity of inner retinal tissues with the cystic formation and subretinal fluids with disturbance of ellipsoid zone with intraretinal hemorrhages. OCT cross-section of macular edema related to branch retinal vein occlusion Diagnosis  This case is branch retinal vein occlusion with macular involvement inducing cystoid macular edema. Management I would treat it promptly with monthly intravitreal AntiVEGF for three consecutive injections and reassess with OCT. Would you observe, or treat with intravitreal AntiVEGF, intravitreal steroids or grid laser?!! Drop a comment below on how you would h...

Sixty-four-year-old pseudophakic known to be diabetic had a history of steroid-induced glaucoma and successfully treated for endophthalmitis with intravitreal antibiotics due to intravitreal Bevacizumab. His vision is counting fingers with central diabetic macular edema managed with Hybridthrehold laser (HT laser). After 24 weeks, there is a reduction of central macular thickening and improved vision up to 20/40 OCT cross-sections before and after treatment with HT laser Disclosure HT laser parameters developed by Ameen Marashi. Please check the  Clinical guidelines for Diabetic retinopathy

X-linked juvenile retinoschisis (XLRS) It is a rare X-linked inherited retinal disease that typically affects males. Mutations of the RS1 gene are responsible for XLRS, which affects Retinoschisin that is responsible for cell to cell adhesion and interaction. In XLRS, a splitting in all retinal layers tissues occurs, which appears as tubular cystic changes on OCT, and clinically presented as Stellate cystic-appearing splitting when affecting the fovea. Also, the gene therapy is under development; carbonic Anhydrase inhibitor may show some improvement on OCT. Fundus image of  X-linked juvenile retinoschisis (XLRS) Please check the clinical guidelines for  X-linked Foveal Retinoschisis

Von Hippel-Lindau in a young female, BCVA, is CF in her left eye. Findings are normal, and BCVA is 20/20. Drop a comment below 👇 telling how would you approach and manage this case ?! I would perform intravitreal AntiVEGF combined with laser treatment. Fundus image showing Von Hipple-Lindau