Based upon the history, symptoms and OCT signs within the above image, what OCT sign do you want to identify or exclude?
Given the age of the patient, they are visually symptomatic and eveidence of outer retinal change on the OCT it is important you include or eliminate the presence of subretinal fluid as this would be indicative of choroidal neovascularization (wet AMD). Age related maculopathy
Assess the following OCT cross sections for the presence of subretinal fluid?
1. Foveal cross section
2. Inferior to fovea
3. Inferior macular
4. Superior macular
None of the images show subretinal fluid, however OCT images 1 & 2 show a cleavage of the RPE from Bruch’s membrane consistent with a shallow RPE detachment. All cross sections show thickening of the RPE and disruption of the outer photoreceptor layers. This change has a marked saw tooth pattern consistent with reticular pseudodrusen. Images 1-3 have a posterior vitreous detachment.
What would be your differential diagnosis?
Would you observe, discharge or refer to hospital eye service?
All four cases are now available, click here to take the test and interactive exercise for Advance Image Interpretation - retinal disease (C31221).
Click to go to page 1, 2, 3, 4, 5,