This patient presented with poor vision. Why?
Analysis
Here there is clear separation from the photoreceptor layer and the RPE as there is sub retinal fluid. This is chronic as we see that there elongation of the photoreceptors. There is also significant hyper reflectivity of the outer plexiform layer as the SRF is pushing this layer anteriorly. On a horizontal cut, there was significant shadowing and a pigmented lesion was noted (video).
The patient was treated for choroidal melanoma.
In this tip's accompanying 11 min. video, we'll review:
- The differential diagnosis of SRF
- How to recognize a double circulation
- How to search for anterior segment clues of melanoma
OCT Tip
In any patient with SRF, consider both retinal vascular causes and neoplastic/tumor causes.
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