Les plus populaires - Eccentric Disciform Scar - Eccentric Subretinal Hemorrhage 88-year-old man was seen in the office on 9/2/2011. He has had glaucoma for several years. He had surgery for that some time ago. He has noticed for the last few months the vision in the right eye is foggy, like there is a film in the eye or a haze, and he does not see well out of the eye. His left eye is also a little bit foggy. He has been diabetic for sixteen years. He stopped his aspirin recently for an ear procedure.
VISUAL ACUITY: His vision is 20/16 in each eye. IOP: 13 in both eyes.
AMSLER GRID: Normal in both eyes.
SLIT LAMP EXAM: There are functioning filtering blebs in both eyes with the posterior chamber intraocular lens in good position in both eyes with open capsules.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.7. The nerve is pale. There are 1+ macular drusen. There is no diabetic retinopathy. In the inferotemporal periphery there is a hemorrhage at the equator at about 7:00 o’clock, which is about 4-disc diameters across and adjacent to that there is scarring.
OS: Vertical C/D ratio is 0.7. There is a posterior vitreous separation. There is a fairly extensive disciform scar in the periphery. Inferotemporally there are 1+ macular drusen.
OCT SCAN: The OCT scan of the macula is normal in both eyes.
FLUORESCEIN ANGIOGRAPHY: There is staining macular drusen in each eye. In the inferior temporal periphery in the right eye there is subretinal hemorrhage which is hypofluorescence, and in the inferotemporal periphery in the left eye there is a staining disciform scar.
IMPRESSION:
1. AGE-RELATED MACULAR DEGENERATION – BOTH EYES
2. ECCENTRIC DISCIFORM SCARS – BOTH EYES
3. BREAKTHROUGH VITREOUS HEMORRHAGE – RIGHT EYE
4. ADVANCED GLAUCOMA
DISCUSSION: I explained to the patient the fog in the right eye is from the bleeding inferotemporally from the eccentric disciform scar. That usually absorbs itself, but if it does not, it would be reasonable to consider either treating the scar with cryotherapy and/or considering vitrectomy.
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Eccentric Disciform Scar - Breakthrough Vitreous Hemorrhage - InferoTemporal Subretinal Fibrosis - Ectopic Choroidal Neovascular Membranesvu 1267 fois88-year-old man has noticed for the last few months the vision in the right eye is foggy, like there is a film in the eye or a haze, His vision is 20/16 in each eye.
Right eye - inferotemporal periphery there is a hemorrhage at the equator at about 7:00 o’clock, which is about 4-disc diameters across and adjacent to that there is scarring.
Left eye - large disciform scar inferotemporally
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Eccentric Disciform Scar - Breakthrough Vitreous Hemorrhage - InferoTemporal Subretinal Fibrosis - Ectopic Choroidal Neovascular Membranesvu 1111 fois88-year-old man has noticed for the last few months the vision in the right eye is foggy, like there is a film in the eye or a haze, His vision is 20/16 in each eye.
Right eye - inferotemporal periphery there is a hemorrhage at the equator at about 7:00 o’clock, which is about 4-disc diameters across and adjacent to that there is scarring.
Left eye - large disciform scar inferotemporally
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Eccentric Disciform Scar - Breakthrough Vitreous Hemorrhage - InferoTemporal Subretinal Fibrosis - Ectopic Choroidal Neovascular Membranesvu 902 fois88-year-old man has noticed for the last few months the vision in the right eye is foggy, like there is a film in the eye or a haze, His vision is 20/16 in each eye.
Right eye - inferotemporal periphery there is a hemorrhage at the equator at about 7:00 o’clock, which is about 4-disc diameters across and adjacent to that there is scarring.
Left eye - large disciform scar inferotemporally
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Eccentric Disciform Scar - Breakthrough Vitreous Hemorrhage - InferoTemporal Subretinal Fibrosis - Ectopic Choroidal Neovascular Membranesvu 826 fois88-year-old man has noticed for the last few months the vision in the right eye is foggy, like there is a film in the eye or a haze, His vision is 20/16 in each eye.
Right eye - inferotemporal periphery there is a hemorrhage at the equator at about 7:00 o’clock, which is about 4-disc diameters across and adjacent to that there is scarring.
Left eye - large disciform scar inferotemporally
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Eccentric Disciform Scar - Breakthrough Vitreous Hemorrhage - InferoTemporal Subretinal Fibrosis - Ectopic Choroidal Neovascular Membranesvu 807 fois88-year-old man has noticed for the last few months the vision in the right eye is foggy, like there is a film in the eye or a haze, His vision is 20/16 in each eye.
Right eye - inferotemporal periphery there is a hemorrhage at the equator at about 7:00 o’clock, which is about 4-disc diameters across and adjacent to that there is scarring.
Left eye - large disciform scar inferotemporally
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Eccentric Disciform Scar - Breakthrough Vitreous Hemorrhage - InferoTemporal Subretinal Fibrosis - Ectopic Choroidal Neovascular Membranesvu 791 fois88-year-old man has noticed for the last few months the vision in the right eye is foggy, like there is a film in the eye or a haze, His vision is 20/16 in each eye.
Right eye - inferotemporal periphery there is a hemorrhage at the equator at about 7:00 o’clock, which is about 4-disc diameters across and adjacent to that there is scarring.
Left eye - large disciform scar inferotemporally
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Eccentric Disciform Scar - Breakthrough Vitreous Hemorrhage - InferoTemporal Subretinal Fibrosis - Ectopic Choroidal Neovascular Membranesvu 779 fois88-year-old man has noticed for the last few months the vision in the right eye is foggy, like there is a film in the eye or a haze, His vision is 20/16 in each eye.
Right eye - inferotemporal periphery there is a hemorrhage at the equator at about 7:00 o’clock, which is about 4-disc diameters across and adjacent to that there is scarring.
Left eye - large disciform scar inferotemporally
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Eccentric Disciform Scar - Breakthrough Vitreous Hemorrhage - InferoTemporal Subretinal Fibrosis - Ectopic Choroidal Neovascular Membranesvu 754 fois88-year-old man has noticed for the last few months the vision in the right eye is foggy, like there is a film in the eye or a haze, His vision is 20/16 in each eye.
Right eye - inferotemporal periphery there is a hemorrhage at the equator at about 7:00 o’clock, which is about 4-disc diameters across and adjacent to that there is scarring.
Left eye - large disciform scar inferotemporally
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Eccentric Disciform Scar - Breakthrough Vitreous Hemorrhage - InferoTemporal Subretinal Fibrosis - Ectopic Choroidal Neovascular Membranesvu 725 fois88-year-old man has noticed for the last few months the vision in the right eye is foggy, like there is a film in the eye or a haze, His vision is 20/16 in each eye.
Right eye - inferotemporal periphery there is a hemorrhage at the equator at about 7:00 o’clock, which is about 4-disc diameters across and adjacent to that there is scarring.
Left eye - large disciform scar inferotemporally
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Eccentric Disciform Scar - Breakthrough Vitreous Hemorrhage - InferoTemporal Subretinal Fibrosis - Ectopic Choroidal Neovascular Membranesvu 721 fois88-year-old man has noticed for the last few months the vision in the right eye is foggy, like there is a film in the eye or a haze, His vision is 20/16 in each eye.
Right eye - inferotemporal periphery there is a hemorrhage at the equator at about 7:00 o’clock, which is about 4-disc diameters across and adjacent to that there is scarring.
Left eye - large disciform scar inferotemporally
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Eccentric Disciform Scar - Breakthrough Vitreous Hemorrhage - InferoTemporal Subretinal Fibrosis - Ectopic Choroidal Neovascular Membranesvu 710 fois88-year-old man has noticed for the last few months the vision in the right eye is foggy, like there is a film in the eye or a haze, His vision is 20/16 in each eye.
Right eye - inferotemporal periphery there is a hemorrhage at the equator at about 7:00 o’clock, which is about 4-disc diameters across and adjacent to that there is scarring.
Left eye - large disciform scar inferotemporally
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Eccentric Disciform Scar - Breakthrough Vitreous Hemorrhage - InferoTemporal Subretinal Fibrosis - Ectopic Choroidal Neovascular Membranesvu 685 fois88-year-old man has noticed for the last few months the vision in the right eye is foggy, like there is a film in the eye or a haze, His vision is 20/16 in each eye.
Right eye - inferotemporal periphery there is a hemorrhage at the equator at about 7:00 o’clock, which is about 4-disc diameters across and adjacent to that there is scarring.
Left eye - large disciform scar inferotemporally
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Eccentric Disciform Scar - Breakthrough Vitreous Hemorrhage - InferoTemporal Subretinal Fibrosis - Ectopic Choroidal Neovascular Membranesvu 653 fois88-year-old man has noticed for the last few months the vision in the right eye is foggy, like there is a film in the eye or a haze, His vision is 20/16 in each eye.
Right eye - inferotemporal periphery there is a hemorrhage at the equator at about 7:00 o’clock, which is about 4-disc diameters across and adjacent to that there is scarring.
Left eye - large disciform scar inferotemporally
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Eccentric Disciform Scar - Breakthrough Vitreous Hemorrhage - InferoTemporal Subretinal Fibrosis - Ectopic Choroidal Neovascular Membranesvu 651 fois88-year-old man has noticed for the last few months the vision in the right eye is foggy, like there is a film in the eye or a haze, His vision is 20/16 in each eye.
Right eye - inferotemporal periphery there is a hemorrhage at the equator at about 7:00 o’clock, which is about 4-disc diameters across and adjacent to that there is scarring.
Left eye - large disciform scar inferotemporally
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Eccentric Disciform Scar - Breakthrough Vitreous Hemorrhage - InferoTemporal Subretinal Fibrosis - Ectopic Choroidal Neovascular Membranesvu 603 fois88-year-old man has noticed for the last few months the vision in the right eye is foggy, like there is a film in the eye or a haze, His vision is 20/16 in each eye.
Right eye - inferotemporal periphery there is a hemorrhage at the equator at about 7:00 o’clock, which is about 4-disc diameters across and adjacent to that there is scarring.
Left eye - large disciform scar inferotemporally
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Eccentric Disciform Scar - Breakthrough Vitreous Hemorrhage - InferoTemporal Subretinal Fibrosis - Ectopic Choroidal Neovascular Membranesvu 577 fois88-year-old man has noticed for the last few months the vision in the right eye is foggy, like there is a film in the eye or a haze, His vision is 20/16 in each eye.
Right eye - inferotemporal periphery there is a hemorrhage at the equator at about 7:00 o’clock, which is about 4-disc diameters across and adjacent to that there is scarring.
Left eye - large disciform scar inferotemporally
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Eccentric Disciform Scar - Breakthrough Vitreous Hemorrhage - InferoTemporal Subretinal Fibrosis - Ectopic Choroidal Neovascular Membranesvu 575 fois88-year-old man has noticed for the last few months the vision in the right eye is foggy, like there is a film in the eye or a haze, His vision is 20/16 in each eye.
Right eye - inferotemporal periphery there is a hemorrhage at the equator at about 7:00 o’clock, which is about 4-disc diameters across and adjacent to that there is scarring.
Left eye - large disciform scar inferotemporally
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Eccentric Disciform Scar - Breakthrough Vitreous Hemorrhage - InferoTemporal Subretinal Fibrosis - Ectopic Choroidal Neovascular Membranesvu 569 fois88-year-old man has noticed for the last few months the vision in the right eye is foggy, like there is a film in the eye or a haze, His vision is 20/16 in each eye.
Right eye - inferotemporal periphery there is a hemorrhage at the equator at about 7:00 o’clock, which is about 4-disc diameters across and adjacent to that there is scarring.
Left eye - large disciform scar inferotemporally
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88-year-old man was seen in the office on 9/2/2011. He has had glaucoma for several years. He had surgery for that some time ago. He has noticed for the last few months the vision in the right eye is foggy, like there is a film in the eye or a haze, and he does not see well out of the eye. His left eye is also a little bit foggy. He has been diabetic for sixteen years. He stopped his aspirin recently for an ear procedure.
VISUAL ACUITY: His vision is 20/16 in each eye. IOP: 13 in both eyes.
AMSLER GRID: Normal in both eyes.
SLIT LAMP EXAM: There are functioning filtering blebs in both eyes with the posterior chamber intraocular lens in good position in both eyes with open capsules.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.7. The nerve is pale. There are 1+ macular drusen. There is no diabetic retinopathy. In the inferotemporal periphery there is a hemorrhage at the equator at about 7:00 o’clock, which is about 4-disc diameters across and adjacent to that there is scarring.
OS: Vertical C/D ratio is 0.7. There is a posterior vitreous separation. There is a fairly extensive disciform scar in the periphery. Inferotemporally there are 1+ macular drusen.
OCT SCAN: The OCT scan of the macula is normal in both eyes.
FLUORESCEIN ANGIOGRAPHY: There is staining macular drusen in each eye. In the inferior temporal periphery in the right eye there is subretinal hemorrhage which is hypofluorescence, and in the inferotemporal periphery in the left eye there is a staining disciform scar.
IMPRESSION:
1. AGE-RELATED MACULAR DEGENERATION – BOTH EYES
2. ECCENTRIC DISCIFORM SCARS – BOTH EYES
3. BREAKTHROUGH VITREOUS HEMORRHAGE – RIGHT EYE
4. ADVANCED GLAUCOMA
DISCUSSION: I explained to the patient the fog in the right eye is from the bleeding inferotemporally from the eccentric disciform scar. That usually absorbs itself, but if it does not, it would be reasonable to consider either treating the scar with cryotherapy and/or considering vitrectomy.
