134. Poor vision after being in bright light
A 53-year-old presents with decreased vision after being in bright light. Why?
Analysis
In this image, there is orderly orientation of the inner retina, from the nerve fiber layer (NFL) down to the outer nuclear layer (ONL). Below the ONL, the external limiting membrane (ELM) is hazy and broken (A). Below this area (A) there is thickening and elevation at the level of the ellipsoid zone (EZ) and RPE. There is evidence of RPE atrophy adjacent to this area of thickening, which is associated with a reverse shadow (B).
The patient was diagnosed with a pattern dystrophy.
In this tip's accompanying 18 min. video, Dr. Sharma takes you through additional diagnostic imagery as well as:
- Learn the common conditions that can present with elevation at the level of the RPE
- Review the morphology associated with different types of macular dystrophy
- Learn that serious systemic disease can be linked to pattern dystrophy
OCT Tip
Elevations of the RPE may be related to pattern dystrophy.
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