Retina Gallery ~ Full Sized Retina Images

Library of Free, Non-Copyrighted Retina Images and Videos

Choose your language:



70-year-old woman in the office on March 28, 2008. She has been on Plaquenil for some time. She has systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. She has noticed over the last several months substantially declining vision in her left eye. She finds it more difficult to read and get along, and especially trying to read the newspaper. She does have severe circulation and clotting problems, necessitating amputation of her left leg and her right foot, for which she is taking Coumadin. VISUAL ACUITY: OD 20/60, OS 20/100. IOP: OD 18, OS 19. SLIT LAMP EXAM: There is 2+ map-dot fingerprint corneal dystrophy in both eyes. The posterior chamber intraocular lens is in good position in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.6. There is peripapillary atrophy. There is a bull’s eye macular area of atrophy. There is no intraretinal or subretinal fluid. OS: Vertical C/D ratio is 0.6. There is peripapillary atrophy. There is also bull’s eye macular atrophy. There is no intraretinal or subretinal fluid. OCT SCAN: The OCT scan of the maculae shows severe foveal atrophy with the central foveal thickness in the right eye of 109 microns, the left eye 138 microns, both of which are well below normal and probably even less than the scan is showing because some of the lines are not accurate. NERVE FIBER LAYER SCAN: The nerve fiber layer scan shows nerve fiber layer atrophy in the left eye more than the right eye with the left eye having a 71 micron thickness on average and in the right eye 85 microns on average. Photos confirm clinical findings. FLUORESCEIN ANGIOGRAM: FA shows well-circumscribed hyperfluorescent circular lesions in both eyes, which do not change at all in the late frames. IMPRESSION: 1. BULLSEYE MACULOPATHY FROM PLAQUENIL TOXICITY – BOTH EYES 2. POSSIBLE CONCOMITANT DRY AGE-RELATED MACULAR DEGENERATION WITH PROGRESSING RETINAL ATROPHY 3. MAT-DOT FINGERPRINT CORNEAL DYSTROPHY – BOTH EYES 4. OPTIC PALLOR – MORE IN THE LEFT EYE THAN THE RIGHT EYE DISCUSSION: I explained to the patient that I do not see any active neovascular disease in either eye, but I am concerned about the vision change recently in the left eye. There are several things that maybe contributing. It may be that the macula is becoming more atrophic just with age-related changes on top of her previous Plaquenil toxicity. It may be that the cornea is an issue. She does have map-dot fingerprint corneal dystrophy. Finally, it may be the optic nerve is becoming more pale in response to circulation problems. I suggested she see you for a comprehensive evaluation and visual field testing. I asked her to take frequent Artificial Tears to see if that will help. I asked her to return here for a check next year.

plaquenilbullseyemac_camu.png
Plaquenil Toxicity - Bulls Eye Maculopathy542 views70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. Recent deceased vision left eye: OD 20/60, OS 20/100. IOP: OD 18, OS 19.
00000
(0 votes)
Add to Favorites
plaquenilbullseyemac_camu_28129.png
Plaquenil Toxicity - Bulls Eye Maculopathy834 views70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. Recent deceased vision left eye: OD 20/60, OS 20/100. IOP: OD 18, OS 19.
00000
(0 votes)
Add to Favorites
plaquenilbullseyemac_camu_28229.png
Plaquenil Toxicity - Bulls Eye Maculopathy483 views70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. Recent deceased vision left eye: OD 20/60, OS 20/100. IOP: OD 18, OS 19.
00000
(0 votes)
Add to Favorites
plaquenilbullseyemac_camu_28329.png
Plaquenil Toxicity - Bulls Eye Maculopathy484 views70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. Recent deceased vision left eye: OD 20/60, OS 20/100. IOP: OD 18, OS 19.
00000
(0 votes)
Add to Favorites
plaquenilbullseyemac_camu_28429.png
Plaquenil Toxicity - Bulls Eye Maculopathy481 views70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. Recent deceased vision left eye: OD 20/60, OS 20/100. IOP: OD 18, OS 19.
00000
(0 votes)
Add to Favorites
plaquenilbullseyemac_camu_28529.png
Plaquenil Toxicity - Bulls Eye Maculopathy270 views70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. Recent deceased vision left eye: OD 20/60, OS 20/100. IOP: OD 18, OS 19.
00000
(0 votes)
Add to Favorites
plaquenilbullseyemac_camu_28629.png
Plaquenil Toxicity - Bulls Eye Maculopathy193 views70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. Recent deceased vision left eye: OD 20/60, OS 20/100. IOP: OD 18, OS 19.
00000
(0 votes)
Add to Favorites
plaquenilbullseyemac_camu_28729.png
Plaquenil Toxicity - Bulls Eye Maculopathy178 views70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. Recent deceased vision left eye: OD 20/60, OS 20/100. IOP: OD 18, OS 19.
00000
(0 votes)
Add to Favorites
plaquenilbullseyemac_camu_28829.png
Plaquenil Toxicity - Bulls Eye Maculopathy157 views70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. Recent deceased vision left eye: OD 20/60, OS 20/100. IOP: OD 18, OS 19.
00000
(0 votes)
Add to Favorites
plaquenilbullseyemac_camu_28929.png
Plaquenil Toxicity - Bulls Eye Maculopathy181 views70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. Recent deceased vision left eye: OD 20/60, OS 20/100. IOP: OD 18, OS 19.
00000
(0 votes)
Add to Favorites
plaquenilbullseyemac_camu_281029.png
Plaquenil Toxicity - Bulls Eye Maculopathy147 views70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. Recent deceased vision left eye: OD 20/60, OS 20/100. IOP: OD 18, OS 19.
00000
(0 votes)
Add to Favorites
plaquenilbullseyemac_camu_281129.png
Plaquenil Toxicity - Bulls Eye Maculopathy178 views70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. Recent deceased vision left eye: OD 20/60, OS 20/100. IOP: OD 18, OS 19.
00000
(0 votes)
Add to Favorites
plaquenilbullseyemac_camu_281229.png
Plaquenil Toxicity - Bulls Eye Maculopathy155 views70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. Recent deceased vision left eye: OD 20/60, OS 20/100. IOP: OD 18, OS 19.
00000
(0 votes)
Add to Favorites
plaquenilbullseyemac_camu_281329.png
Plaquenil Toxicity - Bulls Eye Maculopathy151 views70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. Recent deceased vision left eye: OD 20/60, OS 20/100. IOP: OD 18, OS 19.
00000
(0 votes)
Add to Favorites
plaquenilbullseyemac_camu_281429.png
Plaquenil Toxicity - Bulls Eye Maculopathy296 views70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. Recent deceased vision left eye: OD 20/60, OS 20/100. IOP: OD 18, OS 19.
00000
(0 votes)
Add to Favorites
plaquenilbullseyemac_camu_281529.png
Plaquenil Toxicity - Bulls Eye Maculopathy137 views70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. Recent deceased vision left eye: OD 20/60, OS 20/100. IOP: OD 18, OS 19.
00000
(0 votes)
Add to Favorites
plaquenilbullseyemac_camu_281629.png
Plaquenil Toxicity - Bulls Eye Maculopathy182 views70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. Recent deceased vision left eye: OD 20/60, OS 20/100. IOP: OD 18, OS 19.
00000
(0 votes)
Add to Favorites
plaquenilbullseyemac_camu_281729.png
Plaquenil Toxicity - Bulls Eye Maculopathy186 views70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. Recent deceased vision left eye: OD 20/60, OS 20/100. IOP: OD 18, OS 19.
00000
(0 votes)
Add to Favorites
plaquenilbullseyemac_camu_281829.png
Plaquenil Toxicity - Bulls Eye Maculopathy398 views70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. Recent deceased vision left eye: OD 20/60, OS 20/100. IOP: OD 18, OS 19.
00000
(0 votes)
Add to Favorites
 
19 files on 1 page(s)
Favorites Actions
           

70-year-old woman in the office on March 28, 2008. She has been on Plaquenil for some time. She has systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. She has noticed over the last several months substantially declining vision in her left eye. She finds it more difficult to read and get along, and especially trying to read the newspaper. She does have severe circulation and clotting problems, necessitating amputation of her left leg and her right foot, for which she is taking Coumadin. VISUAL ACUITY: OD 20/60, OS 20/100. IOP: OD 18, OS 19. SLIT LAMP EXAM: There is 2+ map-dot fingerprint corneal dystrophy in both eyes. The posterior chamber intraocular lens is in good position in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.6. There is peripapillary atrophy. There is a bull’s eye macular area of atrophy. There is no intraretinal or subretinal fluid. OS: Vertical C/D ratio is 0.6. There is peripapillary atrophy. There is also bull’s eye macular atrophy. There is no intraretinal or subretinal fluid. OCT SCAN: The OCT scan of the maculae shows severe foveal atrophy with the central foveal thickness in the right eye of 109 microns, the left eye 138 microns, both of which are well below normal and probably even less than the scan is showing because some of the lines are not accurate. NERVE FIBER LAYER SCAN: The nerve fiber layer scan shows nerve fiber layer atrophy in the left eye more than the right eye with the left eye having a 71 micron thickness on average and in the right eye 85 microns on average. Photos confirm clinical findings. FLUORESCEIN ANGIOGRAM: FA shows well-circumscribed hyperfluorescent circular lesions in both eyes, which do not change at all in the late frames. IMPRESSION: 1. BULLSEYE MACULOPATHY FROM PLAQUENIL TOXICITY – BOTH EYES 2. POSSIBLE CONCOMITANT DRY AGE-RELATED MACULAR DEGENERATION WITH PROGRESSING RETINAL ATROPHY 3. MAT-DOT FINGERPRINT CORNEAL DYSTROPHY – BOTH EYES 4. OPTIC PALLOR – MORE IN THE LEFT EYE THAN THE RIGHT EYE DISCUSSION: I explained to the patient that I do not see any active neovascular disease in either eye, but I am concerned about the vision change recently in the left eye. There are several things that maybe contributing. It may be that the macula is becoming more atrophic just with age-related changes on top of her previous Plaquenil toxicity. It may be that the cornea is an issue. She does have map-dot fingerprint corneal dystrophy. Finally, it may be the optic nerve is becoming more pale in response to circulation problems. I suggested she see you for a comprehensive evaluation and visual field testing. I asked her to take frequent Artificial Tears to see if that will help. I asked her to return here for a check next year.