Optometry Commons^™

Outer Macular Holes: A Case Series, Kaitlyn J. Moore Od, Katherine Dunatov Od, Wendy Mcgonigal Od, Karen Reeves Od

Optometric Clinical Practice

Background: Outer foveal microdefects (OFMDs) are small focal photoreceptor interruptions that often present with minimal symptoms and are best identified using optical coherence tomography (OCT).

Case Series: This report describes three cases of outer foveal microdefects discovered incidentally during routine eye examinations.

Conclusion: These cases highlight the importance of OCT in detecting subtle macular abnormalities that may be missed on clinical examination.

Focal Choroidal Excavation Associated With Resolved Central Serous Chorioretinopathy, Loren W. Bennett Od, Katherine M. Mehalik Od

Optometric Clinical Practice

Background: Focal choroidal excavation is a localized concavity of the choroid within the macula defined by its appearance on optical coherence tomography. The condition is typically nonprogressive and often an incidental finding. It may not impact vision, although it can be associated with other visually significant macular pathologies.

Case Report: A 48-year-old male patient presented with a recent history of blurred vision in the left eye. A dilated fundus examination revealed a discrete area of pigment mottling in the macula; both the history and clinical appearance were consistent with resolved central serous chorioretinopathy. Optical coherence tomography did not show residual …

Treatment Considerations For Early Primary Open Angle Glaucoma In Active-Duty Military, Ridwan Carim-Sanni Od, Danielle Kalberer Od, Mba

Optometric Clinical Practice

Background: Glaucoma is one of the leading causes of blindness in the United States. The tools available to treat glaucoma via intraocular pressure (IOP) reduction include pharmacological therapy or surgical intervention.

Case Report: This case study explores these tools in the context of glaucoma in active-duty military personnel. It involves an active-duty army patient diagnosed with early Primary Open Angle Glaucoma (POAG) who was initially prescribed IOP-lowering medication. Barriers in treatment compliance occurred while the patient was deployed that led to significant glaucomatous changes detected when the patient returned stateside.

Conclusion: This report suggests a shift from the traditional pharmacological …

A Case Report Of Vitreopapillary Traction Mistaken For Optic Disc Edema, Breyne Middleton Od, Drew Anderson Od

Optometric Clinical Practice

Background: Traction of the optic disc occurs during incomplete detachment of the posterior vitreous from the peripapillary glial tissue. It can sometimes cause the appearance of disc edema and bilateral cases can be confused with papilledema or cause patients to be worked up for pseudotumor cerebri.

Case Report: A patient presented with an outside diagnosis of unilateral optic disc edema and was found in fact to have vitreopapillary traction.

Conclusion: Costly, ultimately unnecessary testing such as magnetic resonance imaging can be sometimes avoided if vitreopapillary traction is considered as a differential for disc edema. It can be easily identified with …

Applying Multimodal Imaging In The Evaluation Of A Rare Complication Of Retinal Cavernous Hemangioma, Mariana Ferraz Od, Julie Rodman Od, Msc, Jose Diaz Md

Optometric Clinical Practice

Abstract

Background: Retinal cavernous hemangiomas are rare, benign vascular tumors usually encountered incidentally on routine examination. Although usually asymptomatic, complications have been reported and can result in vision loss. Ancillary imaging modalities such as fundus photography, fluorescein angiography, optical coherence tomography, and optical coherence tomography angiography provide valuable information about the lesion and possible associated findings. Case Report: A 66-year-old Caucasian female presented to the clinic for a comprehensive exam with mild blurry vision in both eyes with current spectacles. Her ocular history was remarkable for a retinal cavernous hemangioma along the superior-temporal arcade of the left eye. Dilated fundus …

Altered Outer Retinal Structure, Electrophysiology And Visual Perception In Parkinson's Disease, Bao N Nguyen

Faculty, Staff and Student Publications

BACKGROUND: Visual biomarkers of Parkinson's disease (PD) are attractive as the retina is an outpouching of the brain. Although inner retinal neurodegeneration in PD is well-established this has overlap with other neurodegenerative diseases and thus outer retinal (photoreceptor) measures warrant further investigation.

OBJECTIVE: To examine in a cross-sectional study whether clinically implementable measures targeting outer retinal function and structure can differentiate PD from healthy ageing and whether these are sensitive to intraday levodopa (L-DOPA) dosing.

METHODS: Centre-surround perceptual contrast suppression, macular visual field sensitivity, colour discrimination, light-adapted electroretinography and optical coherence tomography (OCT) were tested in PD participants (n = …

Ocular Manifestations Of Septo-Optic Dysplasia, Rena Cappelli, Od, Tiffany Tucker Christiansen, Od, Danielle Vance Taylor, Od

Optometric Clinical Practice

Background: Septo-optic dysplasia (SOD) is a congenital deformity of the brain which can result in neurologic, systemic, and physical malformation.Due to the proximity of these deformities to the optic chiasm and optic nerves, ocular manifestations are common.

Case Report: A 28-year-old male with a long-standing history of reduced vision presented for a routine eye examination. Upon examination he was found to have an afferent pupillary defect, bilateral optic nerve pallor with corresponding nerve fiber layer thinning by optical coherence tomography. Humphrey visual field testing revealed a bi-temporal visual field defect. Neurological imaging was obtained with a subsequent diagnosis …

Multimodal Imaging Reveals Bilateral Idiopathic Multiple Retinal Pigment Epithelial Detachments: A Case Report, Diana H. Ho, Od, Joseph J. Pizzimenti, Od, Patricia C. Sanchez-Diaz, Dvm, Phd, Stephanie Schmiedecke-Barbieri, Od, Alexandra Zuercher, Od

Optometric Clinical Practice

Background: Retinal pigment epithelial detachment (RPED) is a nonspecific finding that is common in several ocular diseases; however, cases of bilateral idiopathic multiple RPEDs are rare. Less than 50 cases have been reported to date. Bilateral multiple RPEDs are usually idiopathic and benign in nature but can infrequently be associated with various ocular and systemic diseases, including central serous chorioretinopathy (CSC). The potential role of genetic factors in this condition remains elusive. We present a case where multimodal imaging assisted in revealing the diagnosis as well as discuss the potential implications of some of the genetic findings for this …

Retinal Alpha-Synuclein Accumulation Correlates With Retinal Dysfunction And Structural Thinning In The A53t Mouse Model Of Parkinson’S Disease, Bang V Bui

Faculty, Staff and Student Publications

Abnormal alpha-synuclein (α-SYN) protein deposition has long been recognized as one of the pathological hallmarks of Parkinson's disease's (PD). This study considers the potential utility of PD retinal biomarkers by investigating retinal changes in a well characterized PD model of α-SYN overexpression and how these correspond to the presence of retinal α-SYN. Transgenic A53T homozygous (HOM) mice overexpressing human α-SYN and wildtype (WT) control littermates were assessed at 4, 6, and 14  months of age (male and female,

Case Series: Discordance Between Visible Retinal Nerve Fiber Layer Defects And Spectral Domain Optical Coherence Tomographic Analysis In Patients With Glaucoma, Joseph Sowka Od, Leticia Rousso Od

Optometric Clinical Practice

Background: Spectral domain optical coherence tomography (SD-OCT) has become a common modality in glaucoma diagnosis. Ease of use, comfort, and a comparative normative database makes this technology very popular with patients and practitioners. However, despite the sophistication of this technology, it may miss pathologic abnormalities of the retinal nerve fiber layer (RNFL) or be misinterpreted by practitioners based upon comparisons to a normative database.

Purpose: To illustrate discordance between clinical examination and SD-OCT analysis in patients with glaucoma.

Case Reports: Examples of three patients with glaucoma who had photographically and ophthalmoscopically visible RNFL defects who had SD-OCT analyses that fell …