46-year-old with New Blurring

Sanjay Sharma MD, MSc (Epid), MBA

Professor of Ophthalmology, Queen’s University

A 46-year-old presents with recent blurring. This image is consistent with which diagnosis?

oct tip 300

Analysis

There is a bright line on the surface of the retina consistent with an epiretinal membrane. This is causing a loss of the normal foveal depression. In the deeper retina there are numerous areas of hyper-reflectivity in the outer nuclear layer. These lesions had increased signal intensity on autofluorescence and corresponded to yellowish lesions in the deep retinal on fundus examination (see video). In addition there are small areas of elevation in the RPE.

The patient was diagnosed with a pattern dystrophy.

oct tip 300 analysis

Video Analysis

In this tip’s accompanying 8 min. video, we will review:

  • Causes of deep retinal lesion
  • The types of pattern dystrophy
  • How pattern dystrophy is different than AMD

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Clinical Tip

In any patient with deep retinal hyper-reflectivity, consider the possibility of pattern dystrophy.