A 38-year-old presents with blurred vision. This image is consistent with which diagnosis?
Analysis
There are significant areas of retinal thinning, as there is loss of the inner retinal elements, in particular the ganglion cell layer. There is also a significant area of hyperreflectivity on top of the optic nerve, which corresponded to an area of disc neovascularization (video). There was also significant ischemia on OCTA (video).
The patient was diagnosed with DME and proliferative retinopathy.
In this tip's accompanying 4 min. video, we will review:
- Causes of hyperreflectivity
- The 4:2:1 rule
OCT Tip
In any patient with hyperreflectivity anterior to the optic nerve should be considered to have NVD until proven otherwise
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