Macula

Mac Tel SYMPTOMS Typically asymptomatic in the early stages of the disease but eventually may experience central vision loss, central scotomas, and metamorphopsia SIGNS Mac Tel Type 1 (typically unilateral): Telangiectatic retinal capillaries, Cystoid macular edema, Intraretinal hemorrhages, Exudates, Cystoid macular edema with the majority of findings seen temporal to the fovea. There is typically…

Tamoxifen Maculopathy SYMPTOMS Typically asymptomatic in the early stages of the disease but eventually may experience central vision loss and central scotomas SIGNS Typically bilateral Yellow crystalline deposits in the inner retina especially near the ILM, Yellow foveal lesion, Cystoid macular edema, Lamellar macular hole, Full thickness macular hole WORK-UP Full eye exam with dilated…

Plaquenil Maculopathy SYMPTOMS Typically asymptomatic in the early stages of the disease but eventually may experience central vision loss and central scotomas SIGNS Typically bilateral Initially starts off as granular pigment alterations which will eventually turn into a ring of RPE and photoreceptor atrophy in the parafovea and perifovea region (fovea will typically be spared…

Solar Maculopathy SYMPTOMS Decrease in central vision, Central scotoma, Metamorphopsia Visual symptoms occur within 1-4 hours of UV exposure SIGNS Typically bilateral Signs of solar maculopathy may take hours to days to first appear Initially starts as a yellow-white lesion in the fovea region that turns red in 2-4 weeks. Other signs include Faint gray…

Pattern Dystrophy SYMPTOMS Typically asymptomatic but can cause slow progressive central vision loss and metamorphopsia (typically starting at the age of 50 or 60 years old) Rarely sudden central vision loss can occur due to a choroidal neovascular membrane SIGNS Typically bilateral There are 5 main types of pattern dystrophies Adult-Onset Foveomacular Vitelliform Dystrophy (most…

Central Serous Chorioretinopathy (CSCR) SYMPTOMS Decrease in central vision, Metamorphopsia, Micropsia SIGNS Typically unilateral Loss of a foveal reflex, Large neurosensory detachment that appears as a blister which forms an angle of less than 30 degrees from the RPE layer, Small RPE detachments, Pachychoroid Chronic/Non-Resolving central serous chorioretinopathy can be associated with Yellow subretinal precipitates,…

Diabetic Macular Edema (DME) SYMPTOMS Decrease in central vision, Metamorphopsia SIGNS Loss of a foveal reflex, Exudates in the shape of a circinate ring with retinal thickening found in the middle of the exudative ring, Cystic spaces that start in the outer plexiform layer/Henle’s layer with eventual involvement of the inner nuclear layer, Signs of…

Cystoid Macular Edema (CME) SYMPTOMS Decrease in central vision, Metamorphopsia SIGNS Loss of a foveal reflex, Petaloid or honeycomb appearance at the macula due to accumulation of fluid in the outer plexiform layer/Henle’s layer, Cystic spaces that start in the outer plexiform layer/Henle’s layer with eventual involvement of the inner nuclear layer, Signs of associated…

Vitreomacular Traction Syndrome (VMT) SYMPTOMS Central scotoma, Central vision loss, Metamorphopsia May also be asymptomatic especially when vitreomacular traction is minimal SIGNS Loss of a foveal reflex, Glistening translucent membrane visible over the macula, Distortion of the foveal surface, Intraretinal structure changes, Elevation of the sensory retina at the fovea, Tractional cystoid macular edema, Epiretinal…

Full Thickness Macular Hole (FTMH) SYMPTOMS Central scotoma, Central vision loss, Metamorphopsia (size of scotoma and severity of vision loss depends on size and extent of macular hole) SIGNS Gass Classification Stage 1 (Impending macular hole. Vitreal adhesion present) Stage 1a: Yellow spot at the fovea (represents increased prominence of xanthophyll pigment), Foveolar detachment, Pseudocyst…