Case 1
Question 1a: A 67-year-old male presents to an emergency eye clinic with decreased unilateral vision loss from 20/50 to 20/100 OD since the last visit. He had cataract surgery one month prior in this right eye. His most recent HbA1C was 5.4%. The patient’s OCT is shown below.
What abnormalities do you visualize in the patient’s OCT image?
Incorrect. Try again!
Incorrect. Try again!
Incorrect. Try again!
Correct! The answer is (D). All of the above. The abnormalities on the OCT are:
1) Loss of foveal contour and epi-retinal membrane
2) Well-defined intra-retinal cysts
3) Sub-retinal fluid.
Question 1b: What is the Diagnosis?
The Diagnosis is Cystoid Macular Edema
OCT findings associated with CME include loss of foveal depression, diffuse retinal thickening, and intra-retinal fluid as defined by areas of low reflectivity (black) that is often seen in the outer plexiform layer.
A small hypo-reflective cavity is also seen underneath the neurosensory retina indicative of sub-retinal fluid.
Question 1c: Which of the following is the most reasonable first-line therapy for the patient’s diagnosis?
Incorrect. Try again!
Correct! The answer is (B). Topical NSAIDs and Topical Corticosteroids.
Cystoid macular oedema (CME) can be caused by numerous underlying conditions such as diabetic retinopathy, central/branch retinal vein occlusion, uveitis, age-related macular degeneration, and post-operative phenomenon.
Given the patient’s recent history of cataract surgery, and the absence of diabetes in his past medical history, the cause of CME is likely post-operative. A combination of topical NSAIDs and corticosteroids are used in the management of postoperative CME.
Incorrect. Try again!
Incorrect. Try again!
Copyright © 2020 | ODORBN | All rights reserved.