Top rated - Sturge-Weber Encephalotrigeminal Angiomatosis 61-year-old man was seen in the office on 7/2/2010. He has noticed new increased floaters in the right eye: first about three days ago he had some spots, then two days ago a lot of spots, and then just yesterday an explosion of floaters in the eye. You saw a hemorrhage in the eye and suggested he come here for an evaluation. He does have Sturge-Weber syndrome with a hemangioma on the left side of his face.
VISUAL ACUITY: Vision OD is 20/50, PH 20/30; OS 20/80, PH 20/30. IOP: OD 16, OS 19.
SLIT LAMP EXAM: There is 2+ nuclear sclerosis in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.4. There is 2+ vitreous hemorrhage. There is a posterior vitreous separation. There is a retinal flap tear just anterior to the equator at 9:30.
OS: Vertical C/D ratio is 0.4. There is a posterior vitreous separation. It looks to me like there is a reddish dust to the choroid just on the inferior third of the retina just below the macula and the optic nerve.
IMPRESSION:
1. ACUTE POSTERIOR VITREOUS SEPARATION – RIGHT EYE
2. VITREOUS HEMORRHAGE – RIGHT EYE
3. RETINAL TEAR – RIGHT EYE
4. POSSIBLE CHOROIDAL HEMANGIOMA – LEFT EYE
DISCUSSION: I explained to the patient that there is a vitreous separation in the right eye with vitreous hemorrhage and with a retinal tear. With the retinal tear untreated, there is about a 70-80% chance of having a retinal detachment. With treating, we can reduce the risk of retinal detachment from that tear down to 1%.
I treated him with cryotherapy today. Because he has a vitreous hemorrhage, it is a little difficult to see and also because the defect is in the far periphery.
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Sturge-Weber Encephalotigeminal Angiomatosis - Facial Hemangioma and Asymptomatic Ipsilateral Diffuse Choroidal Hemangioma1395 views61-year-old man with Sturge-Weber syndrome with a hemangioma on the left side of his face.
VISUAL ACUITY: Vision OD is 20/50, PH 20/30; OS 20/80, PH 20/30. IOP: OD 16, OS 19.
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Sturge-Weber Encephalotigeminal Angiomatosis - Facial Hemangioma and Ipsilateral Diffuse Choroidal Hemangioma1284 views61-year-old man with Sturge-Weber syndrome with a hemangioma on the left side of his face.
VISUAL ACUITY: Vision OD is 20/50, PH 20/30; OS 20/80, PH 20/30. IOP: OD 16, OS 19.
(1 votes)
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61-year-old man was seen in the office on 7/2/2010. He has noticed new increased floaters in the right eye: first about three days ago he had some spots, then two days ago a lot of spots, and then just yesterday an explosion of floaters in the eye. You saw a hemorrhage in the eye and suggested he come here for an evaluation. He does have Sturge-Weber syndrome with a hemangioma on the left side of his face.
VISUAL ACUITY: Vision OD is 20/50, PH 20/30; OS 20/80, PH 20/30. IOP: OD 16, OS 19.
SLIT LAMP EXAM: There is 2+ nuclear sclerosis in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.4. There is 2+ vitreous hemorrhage. There is a posterior vitreous separation. There is a retinal flap tear just anterior to the equator at 9:30.
OS: Vertical C/D ratio is 0.4. There is a posterior vitreous separation. It looks to me like there is a reddish dust to the choroid just on the inferior third of the retina just below the macula and the optic nerve.
IMPRESSION:
1. ACUTE POSTERIOR VITREOUS SEPARATION – RIGHT EYE
2. VITREOUS HEMORRHAGE – RIGHT EYE
3. RETINAL TEAR – RIGHT EYE
4. POSSIBLE CHOROIDAL HEMANGIOMA – LEFT EYE
DISCUSSION: I explained to the patient that there is a vitreous separation in the right eye with vitreous hemorrhage and with a retinal tear. With the retinal tear untreated, there is about a 70-80% chance of having a retinal detachment. With treating, we can reduce the risk of retinal detachment from that tear down to 1%.
I treated him with cryotherapy today. Because he has a vitreous hemorrhage, it is a little difficult to see and also because the defect is in the far periphery.
