Course name | Date

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".

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.

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.

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.

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.

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.

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.

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.

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.

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”.

Ciliary Body Metastatic Lung Tumor

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

Slit lamp photo with white tumor growing into the sulcus inferior temporally. The Ultrasound Biomicroscopy shows a medium density mass in the ciliary body. The patient had known stage 4 lung cancer.

Chronic Retinal Detachment With Pseudocyst

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Hasenin Al-khersan, MD; Nimesh A. Patel, MD
Presenter/Faculty: Al-khersan, Patel
The pseudocyst (yellow arrow) can be a signal that the retinal detachment is chronic. The ultrasound helps to clearly define the fluid filled cavity. It is thought that these are formed by schisis cavities in the outer plexiform layer. If closure of the primary break is not possible, or if the pseu…

Chronic Retinal Detachment with Laser Demarcation

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

Temporal horseshoe tear with localized retinal detachment. It was demarcated with laser retinopexy and has remained stable.

Chronic Macula on Retinal Detachment with Two Demarcation Lines

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

Patient with a history of pathological myopia and retinal detachment in the fellow eye. Has been stable with a large chronic retinal detachment. There are two demarcation lines noted in the macula. The vision is preserved.

Chronic Macula Changes with Juvenile X-linked Retinoschisis

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

This patient is known to have XLRS and is 80 years old. Over time the macula schisis has led to central atrophy and pigmentary changes. The OCT shows schisis cavities and thinning of the retina.

Christmas Tree Cataract in Myotonic Dystrophy

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

The multicolored appearance is due to needle shaped polychromatic peptide crystals in the cortex or nucleus of the lens. These are not generally visually significant.

Choroidal Osteoma

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

Fundus photo with hypopigmented patch with choroidal thickening temporally. B-scan demonstrates the fundus thickening with mild hyperdensity.

Central Serous Retinal with Choroidal Neovascularization

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

Fundus photos showing sub-retinal angiogenesis with hemorrhage. OCT with pigment epithelial detachment and outer-retinal atrophy. Autofluorescence with a guttering pattern of the atrophy typical with CSR.

Central Retinal Vein Occlusion Associated with Cocaine Abuse

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

A 40-year-old patient with systemic hypertension and history of polysubstance abuse. CBC was within normal limits. Photo shows dilated and engorged vessels, cotton wool spots, and flame hemorrhages.

Carotid Cavernous Fistula with Ocular Ischemic Syndrome

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Andrew J. Rong, MD
Presenter/Faculty: Patel, Rong
Slit lamp photo with dilated epi-scleral veins. Fundus photo with retinal hemorrhages. FA with severe non perfusion, leakage from the disc, and laser scars. MRI/MRA demonstrates left distal precavernous/proximal cavernous ICA fistula into the cavernous sinus with arterialized flow. There is resulta…