Course name | Date

CMV Retinitis with Frosted Branch Angiitis

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

In this condition, vasculitis of both arteries and veins, with translucent exudation, gives a similar appearance to the frosted branches of a tree. (Yellow arrow). Superior nasally, there is also the classic retinal whitening with retinal hemorrhages, also known as a “pizza pie fundus”.

Coats' Disease Stage 4

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

RetCam photo with a bullous exudative retinal detachment. Angiography shows area of engorged vessels, telangiectasias and neovascularization. Ultrasound with moderate dense vitreous opacities and no calcifications. Surgery with external drainage was required for treatment.

Conjunctival Melanoma

Specialty: Ocular Oncology
Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Carol L. Karp, MD; Nimesh A. Patel, MD; Swarup S. Swaminathan, MD
Presenter/Faculty: Karp, Patel, Swaminathan

A large pigmented nasal growth with vascularization. This case was treated with surgery using a 'no touch technique' excisional biopsy with 4 mm margins and amniotic membrane tissue placement.

Cyclodialysis Cleft with Hypotony Maculopathy

Specialty: Glaucoma
Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Elena Bitrian, MD; Nimesh A. Patel, MD; Daniela P. Reyes-Capo, MD
Presenter/Faculty: Bitrian, Patel, Reyes-Capo

This patient presented with low eye pressure post trauma. OCT shows hypotony maculopathy with choroidal folds. Surgery with direct suture pexy was performed. The pressure improved and the maculopathy improved.

Cytomegalovirus Retinitis with Frosted Branch Angiitis

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

Immunocompromised patient with HIV and CMV retinitis. The perivascular inflammation and whitening are known as frosted branch angiitis.

Didanosine Toxicity

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

Patient with HIV on treatment with Didanosine. Fundus photos with peripheral, well circumscribed, patchy choroidal atrophy in both eyes.

Diffuse Unilateral Subacute Neuroretinitis (DUSN) Treated With Laser

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

Fundus photo with multifocal unilateral white dots and central atrophy. On closer inspection a sub retinal nematode is found. Post laser treatment with laser photocoagulation and with many years of follow up there was no progression of the uveitis.

Diffuse Viral Retinitis

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

Immunocompromised patient with HIV presenting with atypical presentation of viral retinitis.

Dislocated White Cataract Mimicking Tumor

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

B-scan ultrasound shows a well circumscribed mass inferiorly with focal hyper-densities. This can mimic a tumor, but the patient has a history of trauma and the object in question is a dislocated crystalline lens.

Emulsified Silicone Oil in Anterior Chamber

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

Silicone oil used in this case was for retinal detachment repair and has emulsified/ It has come to the anterior chamber. The oil is less dense than aqueous fluid and will be found in the superior angle. This is sometimes referred to as a "reverse hypopyon".

Epithelial Ingrowth Post LASIK

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Hasenin Al-khersan, MD; Nimesh A. Patel, MD; Daniela P. Reyes-Capo, MD
Presenter/Faculty: Al-khersan, Patel, Reyes-Capo

Slit lamp photo post LASIK surgery 2 months prior showing patches of cellular material in the the cornea, worse inferiorly. The anterior segment OCT demonstrates the level of the ingrowth is in the interface of the flap.

Euphorbia Keratitis From Milkweed Exposure

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

The patient presented with corneal edema and descemet's folds. The patient noted that she was gardening, and the offending contact was likely euphorbia cyparissias plant sap.

Extruded Scleral Buckle

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

Patient with history of retinal detachment and surgical repair. External photo shows extruded scleral buckle and silicone oil emulsified in the anterior chamber.

Extruded Scleral Buckle with Scleritis

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

First slit lamp photo with normal appearance. In the second slit lamp photo with the eyelid retracted, a tip of the scleral buckle is seen exposed with purulent material. Culture grew mycobacteria.

Familial Drusen with Choroidal Neovascularization

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

Familial Drusen with Choroidal Neovascularization. Also known as Doyne Honeycomb Retinal Dystrophy or Malattia Leventinese.

Fungal Endogenous Endophthalmitis With Breakthrough Viritis

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

Patient with history of intravenous drug abuse. Fundus photo with a creamy yellow superficial retinal lesion in superior macula (arrow). OCT with breakthrough under hyaloid and overlying (arrow).

Fungal Keratitis Post Penetrating Keratoplasty

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Daniel S. Choi, MD; Nimesh A. Patel, MD; Sarah P. Read, MD, PhD
Presenter/Faculty: Choi, Patel, Read

Post penetrating keratoplasty for candida keratitis, this patient developed another foci of infection within the graft tissue. Stromal vascularization and edema can be seen indication failure of the graft.

Grade 5 Papilledema From Idiopathic Intracranial Hypertension

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

Increased intracranial pressure leading to bilateral optic nerve edema. Grade 5 is considered when all vessels are partially obscured by edema.

Intradermal Nevus

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

The patient presented with an enlarging lower eyelid lesion for 2 months. There was irregular pigmentation without ulceration or madarosis. Biopsy confirmed an intradermal nevus.

Intraocular Lymphoma Associated with Non-CNS Lymphoma Treated with Intravitreal Chemotherapy

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Thomas A. Albini, MD; Kenneth C. Fan, MD, MBA; Nimesh A. Patel, MD
Presenter/Faculty: Albini, Fan, Patel
The patient presented with panuveitis and exudative retinal detachment OS. He had a recent skin biopsy of a mass on the arm that was found to be Diffuse large b cell lymphoma ABC type. Diagnostic vitrectomy showed +CD20 cells suggestive of intraocular lymphoma. The follow up photo (2 months later) …