Optometry Continuing Education

OCT Mastery - Tip of the Week (previous)

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128. Hyporeflectivity in retina

A 63-year-old woman presents with blurred vision. Why?

Tip #128


There are significant areas of hyporeflectivity in the central retina due to intraretinal fluid (IRF) which are cystic in nature. There are also areas of scattered hyperreflectivity, located in the outer plexiform layer. These are consistent with exudate (A). There is some thinning of the ellipsoid zone (EZ) and the external limiting membrane (ELM). There is also hyperreflectivity (B) located temporal to the fovea, which is located just deep to the inner nuclear layer. This area of hyperreflectivity Is consistent with mactel.

The patient was also noted to have a small choroidal neovascular membrane (CNV) on OCT angiography.

In this tip's accompanying 18 min. video, Dr. Sharma takes you through additional diagnostic imagery as well as:

  • how to detect lesions on OCTA (OCT angiography)
  • differential for hyperreflective lesions
  • an approach to diagnosing CME
Tip #128


A differential diagnosis of CME should include the presence of mactel.

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