Optometry Continuing Education

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109. Hyperreflectivity in a 34-year-old

A 34-year-old woman presents with poor vision. Why?

Tip #109


On the right of the image, there is normal architecture. The nerve fiber layer (NFL), ganglion cell layer (GC), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL) and outer nuclear layer (ONL) are all within normal limits. In addition, the external limiting membrane, ellipsoid zone and RPE are also within normal limits.

At the center of the image, there is evidence of outer retinal tabulation (ORT) and subretinal fluid (SRF). To the left of the image there is significant hyperreflectivity which appears lamellar in nature and located below the RPE. This area was associated with very high internal reflectivity on ultrasonography and appeared creamy-white.

The patient was diagnosed with a choroidal osteoma.

Tip #108


Fibrosis and neovascularization can be associated with non-AMD lesions, including neoplastic pathologies.

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