The patient was an 81-year-old man with diabetes who had been treated with Avastin for wet AMD in the left eye who had fundus changes in the right eye pictured below. His visual acuity was 20/100 OD and 20/20 OS. There has been no recent change in vision. What is the most likely diagnosis?
This patient had traumatic retinopathy that resulted from being hit in the eye while playing kickball in high school. There was a contusion injury resulting in chorioretinal scarring in the macula and the superior retina. The OCT of the right eye shows central disruption of the retinal laminations and paracentral areas of atrophy central scarring of the outer retina. Though trauma can result in choroidal ruptures leading to a choroidal neovascular membrane, this patient did not have any choroidal ruptures and there was no CNVM.
There is also a small superior nevus in the right eye that will be followed.
The left eye has been receiving Avastin treatments. The OCT reveals a broad, shallow pigment epithelial detachment with central sub-RPE reflective material that likely reflects a choroidal neovascular membrane. There is no subretinal fluid or macular edema.
Regarding the chorioretinal scar in the right eye, there are several other diagnostic considerations. Toxoplasmosis generally has more severe chorioretinal atrophy, and the borders are typically more rounded. Findings in ocular toxocariasis include retinal granulomas, retrolental membrane, and branch-like vitreous strands. Individually, these findings are very sensitive for ocular toxocariasis, and collectively they are very sensitive (Retina 2022;42:934-941). The sectoral nature of the findings in this patient is atypical for inflammatory processes or other infectious processes such as tuberculosis, syphilis, and Lyme disease.
This patient had traumatic retinopathy that resulted from being hit in the eye while playing kickball in high school. There was a contusion injury resulting in chorioretinal scarring in the macula and the superior retina. The OCT of the right eye shows central disruption of the retinal laminations and paracentral areas of atrophy central scarring of the outer retina. Though trauma can result in choroidal ruptures leading to a choroidal neovascular membrane, this patient did not have any choroidal ruptures and there was no CNVM.
There is also a small superior nevus in the right eye that will be followed.
The left eye has been receiving Avastin treatments. The OCT reveals a broad, shallow pigment epithelial detachment with central sub-RPE reflective material that likely reflects a choroidal neovascular membrane. There is no subretinal fluid or macular edema.
Regarding the chorioretinal scar in the right eye, there are several other diagnostic considerations. Toxoplasmosis generally has more severe chorioretinal atrophy, and the borders are typically more rounded. Findings in ocular toxocariasis include retinal granulomas, retrolental membrane, and branch-like vitreous strands. Individually, these findings are very sensitive for ocular toxocariasis, and collectively they are very sensitive (Retina 2022;42:934-941). The sectoral nature of the findings in this patient is atypical for inflammatory processes or other infectious processes such as tuberculosis, syphilis, and Lyme disease.
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