Cases - Canadian Retina Society

Cases

The Canada Retina Society publishes an interesting and educational vitreo-retinal case monthly. We welcome submissions for consideration; please contact us at: admin@crs26.bdes.io

February 26, 2025

Perivenular PAMM

A healthy 43-year-old woman presented to the emergency department with sudden vision loss in her right eye. Ophthalmic examination revealed a visual acuity of 20/32 OD, 20/20 OS, and a normal anterior segment. Dilated fundus examination revealed diffuse venous dilation and tortuosity with associated intraretinal hemorrhage, indicative of a central retinal vein occlusion. Macular examination […]

September 3, 2024

Through the Eyes of Nephritis

Case: A 48-year-old female patient was referred by her optometrist for assessment of dry age-related macular degeneration. She had noted a gradual and painless decrease in her near and distance vision for several years alongside longstanding stable floaters. She denied photophobia, scotoma, and metamorphopsia, and had no history of other ocular diseases or previous ocular […]

December 1, 2023

Plentiful Pigment: A Case of Pigmented Paravenous Retinochoroidal Atrophy

Figure Legend: A: Optos ultra-widefield color fundus photo OS with pigmented chorioretinal lesions following the retinal venous vasculature. The paravenous pigment extends to the periphery with sparing of the macula. Peripapillary pigmentation is present. The arteries, uninvolved retina, vitreous and optic disc are otherwise normal. B: Ultra-widefield Optos fundus autofluorescence photos OS with hypoautofluorescent, well […]

September 15, 2023

Bilateral Sclerochoroidal Calcifications

A 70-year-old male was referred for assessment of bilateral asymptomatic hypopigmented chorioretinal lesions. His ophthalmic history was significant for previous retrobulbar optic neuritis in the right eye. Medical history was significant for previous cerebrovascular accident. On examination visual acuity was 20/30 OD and 20/25 OS. Intraocular pressures were within normal limits. Anterior segment examination was […]

Dark without Pressure Lesions

A 16-year-old man was referred with a two-week history of multiple, small scotomas in his right eye (OD). Upon presentation, visual acuities (VA) were 20/25 OD and 20/20 left eye (OS). Intraocular pressures were 18 mmHg OD and 17 mmHg OS. Anterior segment examination was normal in both eyes (OU). Ophthalmoscopy and ultra-wide field photography […]

A Novel Finding in Fovea-off Rhegmatogenous Retinal Detachment: A Bacillary Layer Detachment (BALAD)

A 50-year-old male presented with a three-day history of central vision loss in his left eye. Visual acuity was 20/400 OS. Dilated fundus exam revealed a fovea-off rhegmatogenous retinal detachment (RRD). Swept-source optical coherence tomography (SS-OCT) confirmed a fovea-involving detachment with evidence of a bacillary layer detachment (BALAD) (white arrow) and mild outer retinal corrugations […]

Double (No) Trouble

A 67-year-old man presented with acute photopsia in his right eye. Clinical examination revealed a visual acuity of 20/25, and a superior retinal break, which was treated with laser retinopexy. Incidentally, macular retinal pigment epithelial changes were noted. A spectral domain OCT was obtained which revealed a shallow and irregular elevation of the retinal pigment epithelium […]

Staining of an Akreos AO60 secondary intraocular lens

An 80-year-old male was booked for removal of a dislocated IOL and placement of a GorTex sutured Akreos AO60 lens. Before implantation a purple mark from the surgical marking pen was noted on the lens (Fig 1). With irrigation and manual scrubbing there was no clearing of the pigment. The lens was discarded and a […]

Bilateral pediatric macular holes

A 25-year-old male was referred for a second opinion of progressively worsening vision OU for the past 14 years. His ocular history was significant for previous diagnosis of macular hole OU as a child. The Fundus exam revealed bilateral large macular holes with yellow/brown pigmentation OU (figure 1). OCT (Optical Coherence Tomography) confirmed the full […]

January 1, 2023

Intra-retinal silicone oil following silicone oil removal

Description: A 58-year-old man presented with a rhegmatogenous retinal detachment (RRD) 1 month following full thickness macula hole repair. He underwent emergent surgery with silicone oil tamponade. Five months later the silicone oil was removed. During the removal, emulsified silicone oil was noted. At his 2-week post-operative review, multiple spherical globules were noted on the […]

November 29, 2022

Plaque in Black: ICG-A in Persistent Placoid Maculopathy

Description: A 60-year-old male presented with headache, fatigue, and 6 weeks of blurry vision secondary to persistent placoid maculopathy. Colour fundus photographs demonstrated yellow-white placoid lesions in the macula OU with associated pigmentary changes (Fig 1A-B). Late-phase indocyanine-green angiography (ICG-A) revealed striking well-demarcated hypocyanescent regions corresponding to the macular lesions noted on colour fundus photography […]

October 31, 2022

Hang in there! Management of Ectopia Lentis

Description: A 56-year-old male presented with decreased vision in the right eye secondary to ectopia lentis. The anterior segment photograph of the right eye captures the subluxing phakic lens. A few remaining intact, but stretched, zonules are visualized to be valiantly hanging on to the descending lens (Fig 1A). The patient underwent a pars plana […]

October 18, 2022

Check your Blind Spot! Perfluoropropane gas in the Optic Nerve Head

Description: A 66-year-old male presented 6 weeks following combined scleral buckle and vitrectomy surgery for a macula-sparing rhegamatogenous retinal detachment for routine follow-up. The patient reported that his C3F8 gas had completely dissipated. In fact, a small bubble remained, but was hiding in his blind spot!

Hiding in plain sight: a case of circumscribed choroidal hemangioma

Case: A 35-year-old female was referred from for a 6-month history of a central scotoma and peripapillary edema in her right eye. Ocular history was significant for a retinal tear treated with laser retinopexy in the right eye 3 months prior. Corrected visual acuity was 6/9 in the affected right eye. Right fundus exam showed […]

Scarring from the Valley

Description: A 26-year-old healthy Hispanic-American female who grew up in the Ohio Mississippi River Valley presented with a two-month history of decreased vision involving the right eye described as a stationary “central spot”. Her past ocular history was significant for myopia OU. On examination, visual acuity with correction was count fingers at 3 feet OD […]

Pie in the eye

A 65-year-old gentleman was referred to the retina service with a 10-year history of nyctalopia and bilateral pigmentary retinal changes, thought to be in keeping with retinitis pigmentosa (RP). Past ocular history was significant only for foreign body. There was no family history of RP. Examination revealed a best-corrected visual acuity of 6/7.5-1 and 6/6-2 in the […]

Subretinal Hemorrhage: Combining medical and surgical modalities

84-year-old male with age related macular degeneration (ARMD) presented 5 days after suddenly losing central vision OS. Medical history was significant for hypertension and benign prostate hypertrophy. Best corrected visual acuity (BCVA) measured 20/30 OD and counting fingers OS. Anterior segments were unremarkable except for PCIOL OU. A large submacular hemorrhage (SMH) OS was visualized […]

When it rains... it pours: A case of retinitis pigmentosa and vasoproliferative tumor

A 12-year old Caucasian female was referred with decreased vision OS. Her past ocular history was remarkable for retinitis pigmentosa, a diagnosis shared by her father. Review of systems and social history were non-contributory. She was not taking any medications. Examination revealed a best-corrected visual acuity of 20/60 OD, and 20/150 OS. Anterior segment examination […]

Made in Asia

An otherwise healthy 43 year old female, originally from the Phillipines, living in Calgary for 38 years, presented to Emergency Department with a fever and flu- like symptoms. Blood cultures were positive for Klebsiella Pneumoniae. The patient was found to have a liver abscess, pneumonia and was started on Intravenous (IV) Ceftriaxone 1 gram BID. […]

February 1, 2021

Luck of the Draw

A 80-year-old female experimented nasal visual field loss in her right eye (OD) with preserved temporal visual field. Her past medical history was significant for age-related macular degeneration and hypertension. Best-corrected visual acuity was 6/6 OD and 6/9 OS. A pupillary afferent defect was present OD. Slip lamp examination was unremarkable in both eyes. Fundus […]