OCT

Two incidental findings, one routine sight test

A 64-year-old woman is referred with an abnormal right macular OCT. The findings are diagnostic of torpedo maculopathy - a rare congenital RPE anomaly. An incidental longstanding peripheral retinal tear is also identified in the left eye, requiring no treatment.

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A vitelliform lesion with a vascular clue

An 87-year-old woman is referred urgently with a working diagnosis of vitelliform macular dystrophy and dot and blot haemorrhages. OCT and careful fundus interpretation point instead to a single unifying diagnosis: an old superotemporal BRVO with secondary ERM and an acquired vitelliform lesion at the fovea.

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Choroidal macrovessel presenting as an incidental OCT abnormality

A 52-year-old asymptomatic man is referred after his first macular OCT reveals a raised area temporal to the fovea. The imaging is typical of a choroidal macrovessel - a benign anomalous dilated choroidal vessel that can mimic more sinister pathology. Confident remote interpretation allowed reassurance without a hospital visit.

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Loss of vision after an elective procedure

A 40-year-old woman wakes from elective endovascular coiling of a paraophthalmic ICA aneurysm with no perception of light in the left eye. Serial OCT over three months illustrates the acute and chronic phases of central retinal artery occlusion, with apparent cilioretinal artery sparing but NPL vision raising the possibility of concurrent ischaemic optic neuropathy.

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