150. New floaters
A 62-year-old with high myopia presents with new floaters. Why?
Analysis
This OCT image is taken from the nasal retina of the right eye. In this image, there is elevation of the retina as there is traction from the vitreous and retina. At the area of traction, there is schisis of the inner retinal layers. There is subretinal fluid and the RPE is thickened with an area of SHRM (subretinal hyperreflective material).
This patient was diagnosed with a vitreo-retinal-choroidal anastomosis (VRCA).
In this tip's accompanying 18 min. video, Dr. Sharma takes you through additional diagnostic imagery as well as:
- Conditions that can present with floaters (including one that can be lethal)
- The pathogenesis of VRCA
- The differential diagnosis of vitreous hemorrhage
OCT Tip
In a patient with retinal neovascularization and previous laser, deep retinal blood may signify the presence of a CNV.
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