32 year old man reports he noticed the floater in the right eye starting in his twenties and it has gotten worse. In the past, an eye doctor six years ago told him he was having a retinal detachment. He grew up in Minnesota and had patching in the left eye for amblyopia in the right eye when he was a young child.
Past medical history is negative. Family history is negative for retinal detachment or blindness of unknown cause. The patient is a nonsmoker and uses no ophthalmic medications. He is currently using a short course of antibiotics and steroids which you prescribed for an upper respiratory infection.
OPHTHALMIC EXAM: Visual acuity without correction of 20/50 OD, 20/25 OS. He reads without correction J1 OD, J2 OS. IOP: 18 OD, 17 OS.
SLIT LAMP EXAM: Biomicroscopy reveals a quiet anterior segment with a clear lens in both eyes. The anterior vitreous is syneretic in the right and well-formed in the left.
POSTERIOR SEGMENT EXAM: There is a clear view with a vitreous separation and a prominent vitreous opacity in the right eye. C/D ratio is 0.3. The left eye shows no vitreous separation, opacity, or hemorrhage. It also has a C/D ratio of 0.3. The macula and large retinal vessels are patent.
EXTENDED OPHTHALMOSCOPY: The retinal periphery shows a pigmented scar present superonasally with an atrophic appearance of the center. There is no evidence of infiltrate around the scar and there is no evidence of hemorrhage associated with this scar. The anterior retina is attached. To scleral depression, there are no tears, breaks, or detachments in either eye.
SPECTRALIS SD-OCT SCAN: Spectral domain scanning shows healthy macula on both sides and a healthy optic nerve on both sides.
FUNDUS PHOTOGRAPHY: Color photography montage captures the floater well, as well as the peripheral scarring. The opacity is circle-shaped and consistent with the patient’s symptoms.
IMPRESSION:
1. SYMPTOMATIC VITREOUS OPACITY IN THE RIGHT EYE
2. CHRPE with Satellite Lesions
3. AMBLYOPIA RIGHT EYE
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Congenital Hypertrophy of the Retinal Pigment Epithelium CHRPE has Satellite Lesions870 views (0 votes)
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Congenital Hypertrophy of the Retinal Pigment Epithelium CHRPE has Satellite Lesions561 views (0 votes)
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Congenital Hypertrophy of the Retinal Pigment Epithelium CHRPE has Satellite Lesions665 views (0 votes)
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Congenital Hypertrophy of the Retinal Pigment Epithelium CHRPE has Satellite Lesions875 views (0 votes)
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32 year old man reports he noticed the floater in the right eye starting in his twenties and it has gotten worse. In the past, an eye doctor six years ago told him he was having a retinal detachment. He grew up in Minnesota and had patching in the left eye for amblyopia in the right eye when he was a young child.
Past medical history is negative. Family history is negative for retinal detachment or blindness of unknown cause. The patient is a nonsmoker and uses no ophthalmic medications. He is currently using a short course of antibiotics and steroids which you prescribed for an upper respiratory infection.
OPHTHALMIC EXAM: Visual acuity without correction of 20/50 OD, 20/25 OS. He reads without correction J1 OD, J2 OS. IOP: 18 OD, 17 OS.
SLIT LAMP EXAM: Biomicroscopy reveals a quiet anterior segment with a clear lens in both eyes. The anterior vitreous is syneretic in the right and well-formed in the left.
POSTERIOR SEGMENT EXAM: There is a clear view with a vitreous separation and a prominent vitreous opacity in the right eye. C/D ratio is 0.3. The left eye shows no vitreous separation, opacity, or hemorrhage. It also has a C/D ratio of 0.3. The macula and large retinal vessels are patent.
EXTENDED OPHTHALMOSCOPY: The retinal periphery shows a pigmented scar present superonasally with an atrophic appearance of the center. There is no evidence of infiltrate around the scar and there is no evidence of hemorrhage associated with this scar. The anterior retina is attached. To scleral depression, there are no tears, breaks, or detachments in either eye.
SPECTRALIS SD-OCT SCAN: Spectral domain scanning shows healthy macula on both sides and a healthy optic nerve on both sides.
FUNDUS PHOTOGRAPHY: Color photography montage captures the floater well, as well as the peripheral scarring. The opacity is circle-shaped and consistent with the patient’s symptoms.
IMPRESSION:
1. SYMPTOMATIC VITREOUS OPACITY IN THE RIGHT EYE
2. CHRPE with Satellite Lesions
3. AMBLYOPIA RIGHT EYE