Medical retina is a complex subspecialty with a steep learning curve, requiring vast and diverse knowledge in basic science, diagnostic imaging, medical treatment, and surgical techniques. Clinical Cases in Medical Retina: A Diagnostic Approach provides highly visual, case-based guidance on the challenging process of gathering patient information, ordering appropriate testing, and arriving at an accurate diagnosis and effective treatment plan. In one convenient volume, it exposes retina fellows and specialists, ophthalmology residents, and other eye care clinicians to a wide variety of patient presentations and scenarios, including rare conditions and special populations.
1. Cover image - p. i 2. Title page - p. ii 3. Table of Contents - p. iii 4. Copyright - p. iv 5. Dedication - p. v 6. Contributors - p. vi 7. Preface - p. xiv 8. List of Illustrations - p. xv 9. List of Tables - p. xvi 10. Section 1. Hereditary Macular Conditions - p. 1 11. 1. Yellow macular spots in a child - p. 2 12. 2. Long-standing photophobia, reduced visual acuity, myopia, and dyschromatopsia in a young adult male patient - p. 9 13. 3. Bilateral progressive severe loss of vision and obesity - p. 17 14. 4. Bilateral peripheral retinal and macular schisis in a young boy - p. 24 15. 5. Congenital blindness and retinopathy in a young girl - p. 31 16. 6. Progressive nyctalopia and tunnel vision in a young man - p. 38 17. 7. Rapid progression of vision loss in a child with pigmentary retinopathy - p. 46 18. 8. Unilateral tractional retinal detachment in a 6-month-old female infant with erythematous skin lesions - p. 50 19. 9. Bilateral peripheral pigmentary changes in a woman - p. 56 20. 10. I was never good at ghosts in the graveyard - p. 61 21. 11. Bilateral perifoveal degeneration in a woman - p. 66 22. 12. Autosomal dominant radial drusen - p. 71 23. Section 2. Degenerative/Deficiency - p. 76 24. 13. Bilateral asymptomatic pigmentary retinopathy - p. 77 25. 14. Unilateral macular schisis with blurred vision in a woman - p. 82 26. 15. Acute vision loss in an elderly patient associated with unilateral intraretinal blot hemorrhage in the macula - p. 88 27. 16. Bilateral macular and peripheral drusen in a young man - p. 95 28. 17. Long-standing macular scars - p. 100 29. 18. Bilateral presentation of bull’s eye maculopathy - p. 107 30. 19. Late-onset nyctalopia and widespread geographical atrophy - p. 113 31. 20. Bilateral gradual visual decline with subtle parafoveal graying and refractile foci - p. 120 32. 21. Transient peripheral white retinal lesions - p. 127 33. 22. Bilateral atypical drusen and slow dark adaptation in a woman - p. 132 34. 23. Bilateral diffuse macular and peripheral yellow spots - p. 139 35. Section 3. Inflammatory/Autoimmune Macular Diseases - p. 145 36. 24. Night blindness in a man with a normal fundus examination - p. 146 37. 25. Hypopyon uveitis - p. 152 38. 26. Treatment-resistant bilateral neurosensory macular detachment - p. 160 39. 27. Malignant photopsias - p. 166 40. 28. Unilateral paracentral scotoma and photopsia in a young woman with myopia - p. 174 41. 29. Persistent bilateral flashes with vitreous cell and haze - p. 180 42. 30. Sudden-onset bilateral scotomas with punched-out, pigmented lesions - p. 186 43. 31. Bilateral Multi-focal serous retinal detachments - p. 195 44. 32. Bilateral multifocal placoid lesions in a young woman - p. 201 45. 33. Bilateral progressive vision loss in an otherwise healthy man - p. 207 46. 34. Flashes and floaters with a well-demarcated peripapillary lesion of the right eye - p. 212 47. 35. Acute vision loss in a pregnant woman associated with bilateral serous retinal detachment - p. 219 48. Section 4. Infectious Macular Diseases - p. 225 49. 36. Unilateral vision loss in a 45-year-old woman - p. 226 50. 37. Unilateral painless vision loss with retinal detachment - p. 231 51. 38. Unilateral vitreous cell and chorioretinal lesions in an asymptomatic woman - p. 237 52. 39. Bilateral chorioretinal scars and pigment mottling in a newborn - p. 242 53. 40. Unilateral floaters and vitreous cells - p. 248 54. Section 5. Retinovascular - p. 253 55. 41. Bilateral retinal hemorrhages in a young man - p. 254 56. 42. Multiple branch retinal artery occlusions in a woman - p. 261 57. 43. Unilateral disc edema in an elderly woman - p. 269 58. 44. Peripheral transient fluctuating retinal lesion - p. 273 59. 45. Acute vision loss with peripapillary cotton wool spots - p. 277 60. 46. Unilateral leukocoria - p. 282 61. 47. Sudden-onset unilateral vision loss in a young patient with a “cherry-red spot” - p. 288 62. 48. Takayasu arteritis: Bilateral progressive loss of vision with aneurysmal dilatation - p. 293 63. 49. Perifoveal retinal whitening and scotomas in a sickle cell patient - p. 299 64. Section 6. Idiopathic Macular Conditions - p. 308 65. 50. A hypopigmented lesion in a baby’s eye - p. 309 66. 51. Unilateral painless vision loss after a viral illness - p. 313 67. 52. Bilateral presentation of macular schisis in a woman - p. 320 68. 53. Bilateral vitelliform detachments in a woman - p. 326 69. 54. Hypopigmented subretinal lesion in an elderly man - p. 331 70. 55. Jello-like circles in my vision - p. 336 71. Section 7. Toxic/Secondary - p. 343 72. 56. Bilateral maculopathy in a middle-aged woman with interstitial cystitis - p. 344 73. 57. Bilateral chronic photopsias in a woman - p. 350 74. 58. Bilateral serous retinal detachments in a man with metastatic melanoma - p. 357 75. 59. Bilateral blurred vision and eye redness with bacillary and serous retinal detachments - p. 364 76. 60. Bilateral decreased vision in a middle-aged man with optical coherence tomography findings of foveal ellipsoid disruption - p. 370 77. 61. Bilateral central scotoma with macular pigmentary changes in a young man - p. 377 78. Section 8. Neoplastic/Infiltrative - p. 383 79. 62. Unilateral exudative retinal detachment in an elderly woman - p. 384 80. 63. Perifoveal calcified lesion in young girl patient - p. 391 81. 64. Bilateral vitreous floaters - p. 397 82. 65. Familial dense vitreous floaters in a man - p. 404 83. 66. Asymptomatic bilateral retinal white spots - p. 412 84. 67. Unilateral decreased vision associated with a peripheral mass in a young male patient - p. 417 85. 68. Peripheral proliferative retinal lesion - p. 423 86. 69. Bilateral severe vision loss in a middle-aged woman with constitutional symptoms - p. 429 87. 70. Diffuse choroidal thickness in a patient with migraine headaches - p. 436 88. 71. Vascularized, pigmented macular lesion - p. 442 89. 72. Unilateral macular lesion in a young ma n - p. 447 90. 73. A young boy who failed routine school screening with unilateral decreased vision and an irregular reddish macular lesion - p. 450 91. 74. Unilateral loss of vision with a vascular retinal lesion - p. 455 92. Index - p. 459
Medical retina is a complex subspecialty with a steep learning curve, requiring vast and diverse knowledge in basic science, diagnostic imaging, medical treatment, and surgical techniques. Clinical Cases in Medical Retina: A Diagnostic Approach provides highly visual, case-based guidance on the challenging process of gathering patient information, ordering appropriate testing, and arriving at an accurate diagnosis and effective treatment plan. In one convenient volume, it exposes retina fellows and specialists, ophthalmology residents, and other eye care clinicians to a wide variety of patient presentations and scenarios, including rare conditions and special populations.
1. Cover image - p. i 2. Title page - p. ii 3. Table of Contents - p. iii 4. Copyright - p. iv 5. Dedication - p. v 6. Contributors - p. vi 7. Preface - p. xiv 8. List of Illustrations - p. xv 9. List of Tables - p. xvi 10. Section 1. Hereditary Macular Conditions - p. 1 11. 1. Yellow macular spots in a child - p. 2 12. 2. Long-standing photophobia, reduced visual acuity, myopia, and dyschromatopsia in a young adult male patient - p. 9 13. 3. Bilateral progressive severe loss of vision and obesity - p. 17 14. 4. Bilateral peripheral retinal and macular schisis in a young boy - p. 24 15. 5. Congenital blindness and retinopathy in a young girl - p. 31 16. 6. Progressive nyctalopia and tunnel vision in a young man - p. 38 17. 7. Rapid progression of vision loss in a child with pigmentary retinopathy - p. 46 18. 8. Unilateral tractional retinal detachment in a 6-month-old female infant with erythematous skin lesions - p. 50 19. 9. Bilateral peripheral pigmentary changes in a woman - p. 56 20. 10. I was never good at ghosts in the graveyard - p. 61 21. 11. Bilateral perifoveal degeneration in a woman - p. 66 22. 12. Autosomal dominant radial drusen - p. 71 23. Section 2. Degenerative/Deficiency - p. 76 24. 13. Bilateral asymptomatic pigmentary retinopathy - p. 77 25. 14. Unilateral macular schisis with blurred vision in a woman - p. 82 26. 15. Acute vision loss in an elderly patient associated with unilateral intraretinal blot hemorrhage in the macula - p. 88 27. 16. Bilateral macular and peripheral drusen in a young man - p. 95 28. 17. Long-standing macular scars - p. 100 29. 18. Bilateral presentation of bull’s eye maculopathy - p. 107 30. 19. Late-onset nyctalopia and widespread geographical atrophy - p. 113 31. 20. Bilateral gradual visual decline with subtle parafoveal graying and refractile foci - p. 120 32. 21. Transient peripheral white retinal lesions - p. 127 33. 22. Bilateral atypical drusen and slow dark adaptation in a woman - p. 132 34. 23. Bilateral diffuse macular and peripheral yellow spots - p. 139 35. Section 3. Inflammatory/Autoimmune Macular Diseases - p. 145 36. 24. Night blindness in a man with a normal fundus examination - p. 146 37. 25. Hypopyon uveitis - p. 152 38. 26. Treatment-resistant bilateral neurosensory macular detachment - p. 160 39. 27. Malignant photopsias - p. 166 40. 28. Unilateral paracentral scotoma and photopsia in a young woman with myopia - p. 174 41. 29. Persistent bilateral flashes with vitreous cell and haze - p. 180 42. 30. Sudden-onset bilateral scotomas with punched-out, pigmented lesions - p. 186 43. 31. Bilateral Multi-focal serous retinal detachments - p. 195 44. 32. Bilateral multifocal placoid lesions in a young woman - p. 201 45. 33. Bilateral progressive vision loss in an otherwise healthy man - p. 207 46. 34. Flashes and floaters with a well-demarcated peripapillary lesion of the right eye - p. 212 47. 35. Acute vision loss in a pregnant woman associated with bilateral serous retinal detachment - p. 219 48. Section 4. Infectious Macular Diseases - p. 225 49. 36. Unilateral vision loss in a 45-year-old woman - p. 226 50. 37. Unilateral painless vision loss with retinal detachment - p. 231 51. 38. Unilateral vitreous cell and chorioretinal lesions in an asymptomatic woman - p. 237 52. 39. Bilateral chorioretinal scars and pigment mottling in a newborn - p. 242 53. 40. Unilateral floaters and vitreous cells - p. 248 54. Section 5. Retinovascular - p. 253 55. 41. Bilateral retinal hemorrhages in a young man - p. 254 56. 42. Multiple branch retinal artery occlusions in a woman - p. 261 57. 43. Unilateral disc edema in an elderly woman - p. 269 58. 44. Peripheral transient fluctuating retinal lesion - p. 273 59. 45. Acute vision loss with peripapillary cotton wool spots - p. 277 60. 46. Unilateral leukocoria - p. 282 61. 47. Sudden-onset unilateral vision loss in a young patient with a “cherry-red spot” - p. 288 62. 48. Takayasu arteritis: Bilateral progressive loss of vision with aneurysmal dilatation - p. 293 63. 49. Perifoveal retinal whitening and scotomas in a sickle cell patient - p. 299 64. Section 6. Idiopathic Macular Conditions - p. 308 65. 50. A hypopigmented lesion in a baby’s eye - p. 309 66. 51. Unilateral painless vision loss after a viral illness - p. 313 67. 52. Bilateral presentation of macular schisis in a woman - p. 320 68. 53. Bilateral vitelliform detachments in a woman - p. 326 69. 54. Hypopigmented subretinal lesion in an elderly man - p. 331 70. 55. Jello-like circles in my vision - p. 336 71. Section 7. Toxic/Secondary - p. 343 72. 56. Bilateral maculopathy in a middle-aged woman with interstitial cystitis - p. 344 73. 57. Bilateral chronic photopsias in a woman - p. 350 74. 58. Bilateral serous retinal detachments in a man with metastatic melanoma - p. 357 75. 59. Bilateral blurred vision and eye redness with bacillary and serous retinal detachments - p. 364 76. 60. Bilateral decreased vision in a middle-aged man with optical coherence tomography findings of foveal ellipsoid disruption - p. 370 77. 61. Bilateral central scotoma with macular pigmentary changes in a young man - p. 377 78. Section 8. Neoplastic/Infiltrative - p. 383 79. 62. Unilateral exudative retinal detachment in an elderly woman - p. 384 80. 63. Perifoveal calcified lesion in young girl patient - p. 391 81. 64. Bilateral vitreous floaters - p. 397 82. 65. Familial dense vitreous floaters in a man - p. 404 83. 66. Asymptomatic bilateral retinal white spots - p. 412 84. 67. Unilateral decreased vision associated with a peripheral mass in a young male patient - p. 417 85. 68. Peripheral proliferative retinal lesion - p. 423 86. 69. Bilateral severe vision loss in a middle-aged woman with constitutional symptoms - p. 429 87. 70. Diffuse choroidal thickness in a patient with migraine headaches - p. 436 88. 71. Vascularized, pigmented macular lesion - p. 442 89. 72. Unilateral macular lesion in a young ma n - p. 447 90. 73. A young boy who failed routine school screening with unilateral decreased vision and an irregular reddish macular lesion - p. 450 91. 74. Unilateral loss of vision with a vascular retinal lesion - p. 455 92. Index - p. 459
