By Dr.Ameen Marashi
60 year old lady with no medical history BCVA 6/6 6/36 and IOP 12-13 what is your Ds and DDx
By Dr.Osama Tommalieh Papille is pale,,,, Macula with cellophan reflex and folding,we need oct macula. DDx. Macular pucker, vitreomacular traction syndrome.
The temporal blood vessels are tortuous and pulled towards the macula (in the picture the inferior blood vessels
have been pulled inwards more than the superior). The macula surface is wrinkled (sometimes with retinal folds).
In advanced cases, there may be distinct fibrous tissues.
Look for possible causes:
- diabetes mellitus with pan-photocoagulation.
- evidence of past vein occlusion (tortuous and dilated blood vessels with flame and dot and blot haemorrhages)
- retinal hole with or without previous laser or cryotherapy.
- Retinal procedures such as detachment surgery, photocoagulation and cryotherapy.
- Idiopathic. This tends to affect the elderly and is bilateral in 5% of cases.