Editor's note: The images featured here were chosen as runners up to the winning photo on the cover of this issue of Retina Today. Case descriptions and photographer information accompany each image.

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RED SHADE

Red Shade

A 38-year-old female with a negative ophthalmic history was referred to our ophthalmic department with an acute onset of blurred vision and complaining of seeing a red shade in her right eye. There was no ocular trauma nor valsalva. The medical history was notable for chronic pain due to a history of congenital hip dysplasia, and the patient was taking arcoxia 60 mg, mirtazapine 15 mg, oxynorm 10 mg, oxynorm 5 mg, oxycondon 5 mg, oxycodon 20 mg, osipine 20 mg, ranitidine 150 mg, ibuprofen 600 mg, diazepam 5 mg, gabapentine 100 mg, loperamide 2 mg, furosemide 40 mg 1dd1, and metoprolol ret 100 mg 1dd1. She had a history of alcohol and cocaine use.

The uncorrected distance visual acuities were 20/200 right eye (OD) and 20/20 left eye (OS). Anterior segment imaging showed clear cornea and media in both eyes. Fundoscopic examination revealed a central sub-internal limiting membrane (ILM) hemorrhage with multiple dot and blot spots in the periphery in the right eye and no abnormalities in the left eye. We suggested Nd:YAG lase; however, the patient was lost to follow-up. The concluding diagnosis was sub-ILM hemorrhage most likely due to cocaine use.

Image from Jocelyn Kasanardjo
 Gelre Ziekenhuizen
Zutphen
The Netherlands
Imaging Technology: TRC-NW8
Nonmydriatic Camera (Topcon)

JUVENILE RETINOSCHISIS

juvenile retinoschisis

An 8-year-old boy presented for a routine ophthalmology appointment, during which reduced visual acuity was detected and measured: 0.4 OD and 0.8 OS. Upon fundoscopy, bilateral and quite symmetrical retinal changes were found in both eyes. In the right eye, an inferior white line crossed the retina, associated with pigment clumps and coriorretinal atrophy areas at its end; the fovea revealed quistic changes. The left eye similarly presented with an inferior line topped with coriorretinal atrophy. The fovea also had a quistic appearence, but less pronounced. The vitreous was hyperplastic in both eyes. These findings were documented with optical coherence tomography.

Image from Maria Inês Rodrigues and António Ramalho
Hospital Espirito Santo
Évora
Portugal
Imaging Technology: Visucam 500
(Carl Zeiss Meditec)

METALLIC INTRAOCULAR FOREIGN BODY

metallic intraocular foreign body

A 56-year-old white man presented with what he described as a burning sensation in his eye after removing a wheel bearing with a hammer. A pars plana vitrectomy was performed, and the metal fragment was removed with end-grasping forceps. Endophotocoagulation was applied around the retinal defect, and fluid-gas exchange was performed. Postoperative visual acuity was stabilized at 20/25.

Image from Byron Wood, BA, CRA
Charles Retina Institute
Memphis
USA
Imaging Technology: Visucam Pro-NM
(Carl Zeiss Meditec)

RETINOPATHY OF PREMATURITY

retinopathy of prematurity

A 41-week-old ex-premature infant presented with stage 3, zone 2 retinopathy of prematurity. We used ultra-widefield fluorescein angiography to demonstrate persistent leakage despite previous laser therapy.

Image from Timothy Fung, Lewis Smith, CK Patel
Oxford University Eye Hospital
Oxford
UK
Imaging Technology: Optomap (Optos)