Course name | Date

Pediatric Leber's Hereditary Optic Neuropathy

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Maja Kostic, MD, PhD; Byron L. Lam, MD; Nimesh A. Patel, MD
Presenter/Faculty: Kostic, Lam, Patel

A 7-year-old patient with fundus photos showing temporal optic nerve pallor OU. Vision was 20/400 and 20/800. Ganglion cell layer of the patients male first cousin reveals diffuse thinning.

Penetrating Ocular Trauma with Staple Gun

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Jacob S. Duker, MD; Nimesh A. Patel, MD
Presenter/Faculty: Duker, Patel

The large staple was able to be surgically removed and was performed with phacoemulsification of the lens.

Peripapillary Congenital Hypertrophy of the Retinal Pigment Epithelium (CHRPE)

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Micheal C. Yim, MD
Presenter/Faculty: Patel, Yim

Pigmented lesion in the peripapillary area with lacunae suggesting chronicity.

Peripheral Ulcerative Keratitis

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Jesse D. Sengillo, MD; Patrick Staropoli, MD
Presenter/Faculty: Patel, Sengillo, Staropoli

Inferior peripheral corneal thinning due to systemic inflammatory disease. Surgery was with conjunctival recession and amniotic membrane placement.

Peripheral Ulcerative Keratitis

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Guillermo Amescua, MD; Nimesh A. Patel, MD; Humberto Salazar, III, MD
Presenter/Faculty: Amescua, Patel, Salazar
Peripheral crescentic ulceration and thinning along limbus from 0600 to 1200 with superior neovascularization associated with pain. Treatment was initially with lubrication, antibiotic, systemic steroids, vitamin C, and doxycycline. Ultimately, the patient needed conjunctival recession with AMT pla…

Polypoidal Choroidal Vasculopathy

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Kenneth C. Fan, MD, MBA; Nimesh A. Patel, MD
Presenter/Faculty: Fan, Patel

Fundus photo with a nasal peripapillary sub retinal vascular complex surrounded by exudation. OCT with pigment epithelial detachment and associated sub-retinal fluid. ICG angiography makes the diagnosis clear with a hypercyanescent polyp in the choroid.

Pseudoxanthoma Elasticum with Angioid Streaks

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Kenneth C. Fan, MD, MBA; Nimesh A. Patel, MD
Presenter/Faculty: Fan, Patel

External photo depicting characteristic yellow papules, or p'eau d'orange, on the neck. Fundus photos with angioid streaks (yellow arrows).

Ruptured Macroaneurysm with Sub-Macula Hemorrhage Treated with TPA and Pneumatic Displacement

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Jorge Fortun, MD; Nimesh A. Patel, MD; Andrew J. Rong, MD
Presenter/Faculty: Fortun, Patel, Rong

The patient presented with a RAM and sub-macular hemorrhage. Treatment was with pars plana vitrectomy, sub-retinal tissue plasminogen activator injection and 26% SF6 gas. The hemorrhage resolved with some photoreceptor changes, but no fibrosis and the patient regained 20/40 vision.

Silicone Oil Droplets on a Silicone Intraocular Lens

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Harry W. Flynn, Jr., MD; Diana M. Laura, MD; Nimesh A. Patel, MD
Presenter/Faculty: Flynn, Laura, Patel

Silicone oil droplets on a silicone intraocular lens

Sub Internal Limiting Membrane Hemorrhage in a Patient With Leukemia

Specialty: Ocular Oncology
Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Brandon Sparling
Presenter/Faculty: Patel, Sparling

Large sub-ILM hemorrhage leading to sub-retinal exudative changes in a patient with leukemia.

Sub-Conjunctival Lens Migration

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Ashley M. Crane, MD; Nimesh A. Patel, MD
Presenter/Faculty: Crane, Patel

Patient with history of multiple retinal detachments with a phthisis eye. The crystalline lens is noted to have migrated external to the sclera and subconjunctivally.

Susac Syndrome

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Janet L. Davis, MD; Nimesh A. Patel, MD; Andrew J. Rong, MD
Presenter/Faculty: Davis, Patel, Rong
A 40-year-old female with headaches, hearing loss and a superior scotoma in the right eye. Fundus photo with multiple inferior branch retinal artery occlusions. Angiography with non-filling of the inferior arterioles and capillary dropout in the area of the infarct. MRI showed scatter FLAIR lesions…

Toxocara with Tractional Retinal Detachment

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Audina M. Berrocal, MD; Nimesh A. Patel, MD
Presenter/Faculty: Berrocal, Patel

The temporal toxocara lesion led to sub retinal exudation, macular fold and tractional retinal detachment. Surgery was performed with pars plana vitrectomy.

Tractional Retinal Detachment From Proliferative Diabetic Retinopathy

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Kenneth C. Fan, MD, MBA; Nimesh A. Patel, MD; Jonathan F. Russell, MD, PhD
Presenter/Faculty: Fan, Patel, Russell

The traction retinal detachment has taken on a napkin ring configuration.

Traumatic Choroidal Rupture

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Alison K. Bozung, OD; Nimesh A. Patel, MD
Presenter/Faculty: Bozung, Patel

The curvilinear breaks in Bruch’s membrane and found with some mild associated sub-retinal hemorrhage. Infrared image depicts the patterns of rupture.

Usher Syndrome

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Brandon Sparling
Presenter/Faculty: Patel, Sparling

Fundus photo with central and peripheral retinal atrophy as well and bone spicule RPE changes. This patient also had characteristic hearing loss.

Wegner's Syndrome with Tractional Retinal Detachment

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Audina M. Berrocal, MD; Nimesh A. Patel, MD
Presenter/Faculty: Berrocal, Patel

This patient was diagnosed with genetic testing to have the hereditary vitreoretinopathy, Wegner's Syndrome. The abnormal vitreoretinal interface leads to a focal tractional retinal detachment of the macula. Post-operative photo and OCT show resolution of the detachment after vitrectomy.

Wyburn-Mason Syndrome

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Audina M. Berrocal, MD; Brenda Fallas; Kenneth C. Fan, MD, MBA; Nimesh A. Patel, MD
Presenter/Faculty: Berrocal, Fallas, Fan, Patel

Fundus photo with retinal arteriovenous malformation emanating from the nerve. FA shows filling of the vessels without leakage. MRI is needed to assess for intracranial AVMs.

Cranial Nerve 6 Palsy from Metastatic Cholangiocarcinoma

Type: Online Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Benjamin J. Fowler, MD, PhD
Faculty Discussant(s): Byron L. Lam, MD
Presenter/Faculty: Fowler, Lam
Cranial Nerve 6 Palsy from Metastatic Cholangiocarcinoma A 34-year-old woman presented with 2 weeks of diplopia. The patient had binocular horizontal diplopia with a right cranial nerve 6 palsy and moderate-to-severe headache of 1-week duration. Magnetic resonance imaging (MRI) of the brain and orb…

Iridodialysis Repair in a Phakic Patient

Type: Surgical Videos
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Justin H. Townsend, MD
Presenter/Faculty: Patel, Townsend