Digital Grand Rounds - Case #82

Clinical Photo

History / Objective Data

Brian P. Den Beste, OD was kind enough to donate this excellent case for use in the DGR series. Thanks, Brian!

A 21-year-old black female complains of poor vision in her right eye. It began suddenly two weeks ago, and has not improved or worsened since. She states that prior to the event she was 20/20. She denies having hypertension, cardiovascular disease, diabetes, kidney trouble, migraines, any history of surgeries, trauma or "any other illness". Her ocular history is unremarkable.

Uncorrected visual acuity is 20/200 in the right eye, 20/20 in the left. Motilities are full and smooth. Confrontation fields are full to finger counting in each eye. Pupils are normal. Amsler grid testing shows a central scotoma in the right eye; the left eye is normal. Goldmann tonometry measures intraocular pressures of 16mm Hg in each eye. The patient's blood pressure is 122/82.

Dilated ophthalmoscopy of of the right eye reveals the appearance seen in the upper-left fundus photo. The right eye also displayed areas of RPE hyperplasia in the periphery. The left eye is normal. The other three photos depict the fundus appearance at follow-up visits two weeks, four weeks, and six months.

What is this condition?

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[Answer/Discussion]

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Thanks!

Walt Mayo, OD

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