Diseases of the Optic Nerve

Case 14-2 continued

Optical Coherence Tomography

A vertical OCT image through the fovea (B; white line on A) showed thickening of the central macula related to cystic changes or splitting of the outer retina. Vertical structures appeared to bridge the outer and inner retina.

A scan taken through the optic disc (C; black line on A) showed cystic changes in both the inner and outer retina contiguous with the edge of the optic disc.

Follow-up Examination

Two months later, the patient returned with a decline in visual acuity to counting fingers. Dilated fundus examination (D) revealed a new, well-defined serous detachment in the central macula with persistent overlying cystic degeneration.

Follow-up Optical Coherence Tomography

Follow-up OCT examination (E) confirmed the development of a neurosensory detachment centrally beneath intraretinal fluid accumulation in the outer retinal layers. The detachment was well circumscribed and did not communicate with the optic disc.

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