Good Hope, Heartlands, and Solihull Eye Clinics

Medical retina cases

David Kinshuck Congress 16

 

 

Med ret case 1

  • 19y f, 4/60bilt, loss of sight
  • Fibrosis bilateral fovea and multifocal white retinal areas
  • Bloods.. Tpr neg lyme neg, subretinal fibrosis multifocal schlagal lines
  • sight poor for years ..stargardts 6/60
  • Only new thing was the fibrosis, flecks from stargardts >> areas of atrophy
  • ?Did smoking cause fibrotic hyperplasia 
  • Multifocal Choroiditis in patient with stargardts...bird
    Multifocal Choroiditis...? Infective, perhaps secondary to fibrosis <<< smoking

Case2

  • 36y lady 8d myope,
  • Lived abroad
  • Presented with shadow detachments, settled,.years ago
  • Ppcnv... Treated of injections
  • subretinal fibrosis syndrome, hsv 6, hiv neg
  • Hiv 6 but was longstanding, mycophenylate, and prednisolone , one focus...Lucentis 
  • ? Hsv6 relevant 
  • Left eye.  ? Subretinal fibrosis syndrome,  ? diagnosis 

Case3

  • 28 y f, photopsia,
  • grey vision, blurred,days,
  • Arn..cnv..no vitreous cells
  • Hsv >> Acv

Case 5

  • 65y f, week of floaters
  • Fluffy white lesion nasal,
  • Vessel flouresence, reticular drusen,cxr,bloods, 
  • Steroids high dose
  • 1 week much worse..acute retinal necrosis...valaciclovir,doxycycline, worse still 1 week,
  • later,reduce steroids,
  • valcyclovir continues,
  • Vmt..vitrectomy....detached
  • Arn can present very atypically, no steroids at onset,

Case6

  • 42 lady
  • Type 1 dm25 y, well controlled , lots of laser
  • 6/9, 
  • Vit haemorrhages, multiple venous macroaneurysms..these are termed raspberries, ...nve with pvd.,
  • Risk of bleeding low because vit detached 

Case 7

  • 52y, male
  • Abnormal appearance left mac, good vision.
  • Icg abnormal Choroidal vessel ? Nematode, ???? Congenital 
    6/18 vision


Case 8

  • Thalassaemia
  • Cmo inner and outer retina...mac tel

Case 10 

  • Mac tel neuro.glial disease...
  • tamoxifen just bringing it earlier ...muller cell
  • Mt...genetic...  Mt look at siblings ...bird wants sibling pairs
  • Blue light reflectance red free, much more obvious with dark adaptation.