Browse All - American Academy of Ophthalmology

AAO-AAPOS Journal Club November 2019 (ABO Quarterly Questions)

Dec 03, 2019

Drs. Epley and Orge moderate this virtual journal club with Drs. Pennesi, Ghadban, and Abramson. Articles included: Treatment of Retinoblastoma in 2015: Agreement and Disagreement (David H. Abramson, MD, FACS); The incidence and clinical characteristics of adult-onset convergence insufficiency (Rafif Ghadban, MD); and Results at 2 Years after Gene Therapy for RPE65-Deficient Leber Congenital Amaurosis and Severe Early-Childhood-Onset Retinal Dystrophy (Mark Pennesi, MD)

Presentations and Lectures Video

Comments 0
Views 37

Inferior keratitis

Nov 26, 2019

A, Inferior keratitis secondary to severe blepharitis. B, Fluorescein staining of keratitis (same patient as in part A).

Image

Comments 0
Views 2

Apert syndrome.

Nov 26, 2019

Broad forehead, midfacial retrusion, and marked syndactyly in a patient with Apert syndrome.

Image

Comments 0
Views 9

Bilateral sclerocornea

Nov 26, 2019

Bilateral sclerocornea.

Image

Comments 0
Views 9

Anophthalmia

Nov 26, 2019

A,Anophthalmia, both eyes. B, Magnetic resonance image from a patient with unilateral anophthalmia shows absence of ocular structures.

Image

Comments 0
Views 4

Chlamydial ophthalmia neonatorum

Nov 26, 2019

Chlamydial ophthalmia neonatorum.

Image

Comments 0
Views 4

Left inferior oblique palsy

Nov 26, 2019

Left inferior oblique palsy. When the patient fixates with the paretic eye, there is a right hypertropia in primary position that is also most prominent in right gaze and with head tilt to the right—the 3-step test is consistent with this diagnosis. This patient had no abnormal neurologic findings.

Image

Comments 0
Views 5

Stargardt disease

Nov 26, 2019

Fundus photographs from a patient with Stargardt disease. The right eye (A) and left eye (B) demonstrate classic pisciform yellow-white flecks throughout the macula, with mottling of the central retinal pigment epithelium (RPE). Corresponding right (C) and left (D) fundus autofluorescence (FAF) images reveal mottled hypo- and hyperautofluorescence with hyperautofluorescent flecks (corresponding to the pisciform flecks) and a bull’s-eye maculopathy, greater in the left eye than in the right eye.

Image

Comments 0
Views 5

Gardner Syndrome

Nov 26, 2019

Gardner Syndrome. A, Ultra-wide-angle fundus photograph shows multiple pigmented retinal lesions with areas of depigmentation oriented radially to the optic nerve. B, FAF reveals areas of hypo- and hyperautofluorescence within pigmented lesions. C, Retinal lesion with a “fish-tail” configuration.

Image

Comments 0
Views 5

Superficial optic disc drusen

Nov 26, 2019

A, Superficial optic disc drusen, right eye. B, Appearance with autofluorescence. C, Optical coherence tomography image from a different child with drusen reveals the typical “lumpy bumpy” appearance.

Image

Comments 0
Views 3

Knobloch syndrome

Nov 26, 2019

Knobloch syndrome. A, With severe chorioretinal atrophy. B, With cryptless iris. C, With scalp abnormality.

Image

Comments 0
Views 3

The 3-step test

Nov 26, 2019

The 3-step test. The cyclovertical muscles are represented in their fields of action. A, Step 1: Right eye higher than left suggests weakness in 1 of the 2 depressors of the right eye (RIR or RSO) or in 1 of the 2 elevators of the left eye (LIO or LSR). B, Step 2: If the deviation furthermore worsens on left gaze, this implicates either the RSO or the LSR. Note that at the end of step 2, 1 depressor and 1 elevator of opposite eyes will be identified as the possible weak muscle. C, Step 3: If the right eye is furthermore higher in right head tilt than left head tilt, there is weakness of the RSO: right head tilt induces intorsion of the right eye, which depends on activation of both the RSO (a depressor) and the RSR (an elevator), and extorsion of the left eye, from activation of both the LIO (an elevator) and the LIR (a depressor). This rules out the LSR (which was still a candidate at the end of Step 2), and identifies the RSO as the weak muscle. LIO = left inferior oblique; LIR = left inferior rectus; LSR = left superior rectus; RIR = right inferior rectus; RSO = right superior oblique; RSR = right superior rectus.

Image

Comments 0
Views 4

Vernal keratoconjunctivitis

Nov 26, 2019

VKC with shield ulcer.

Image

Comments 0
Views 1

Schnyder corneal dystrophy

Nov 26, 2019

Corneal crystals in a girl with Schnyder corneal dystrophy.

Image

Comments 0
Views 1

Alternate cover test.

Nov 26, 2019

A,The alternate cover test. Top: Exotropia, left eye fixating. Middle and bottom: Both eyes move each time the cover alternates from one eye to the other. B, The prism alternate cover test. Top: The exotropia is neutralized with a prism of the correct power. Middle and bottom: The eyes do not move as the cover alternates from one eye to the other.

Image

Comments 0
Views 1

Juvenile retinoschisis

Nov 26, 2019

Three-year-old with juvenile retinoschisis. A, Central and extensive peripheral retinoschisis with mild vitreous and preretinal hemorrhage. There is a large circumferential tractional retinal detachment around the arcades, encroaching on the central macula. A retinal hole is also present. B, Fluorescein angiography reveals an extensive tractional detachment. C, Macular OCT image demonstrates retinoschisis with a tractional detachment and subretinal fluid encroaching on the fovea.

Image