Retinography

Macular pseudohole

Ricardo Leitão Guerra, MD

68yo

Macular pseudohole is characterized by a steepened foveal contour without a full-thickness defect. On Optical Coherence Tomography (OCT), it shows a narrow, deep foveal pit with intact outer retinal layers, typically caused by a contractile epiretinal membrane (ERM). Differentiating it from a true macular hole is essential, as visual prognosis and management differ significantly.

MacTel type 2

Ricardo Leitão Guerra, MD

55yo

In macular telangiectasia type 2 (MacTel), the OCTA depth-enhanced map improves visualization of vascular alterations across different retinal layers. It highlights capillary rarefaction and telangiectatic vessels, particularly in the deep capillary plexus and outer retina. This tool enhances diagnostic accuracy and monitoring of neovascular complications in MacTel.

Choroidal nevus

Ricardo Leitão Guerra, MD

57yo

Choroidal nevus is best visualized using near-infrared reflectance (NIR) imaging. Its appearance may vary: it can be hyperreflective in confocal systems or hyporeflective in non-confocal imaging, depending on the imaging modality and melanin density. NIR enhances contrast for detecting and monitoring nevi, especially when they are not clearly visible on color fundus photography or FAF.

Asymptomatic BRVO

Ricardo Leitão Guerra, MD

68yo

A superior nasal branch retinal vein occlusion (BRVO) is usually asymptomatic, as the macula is typically spared. These cases are often identified incidentally during routine examination. Fluorescein angiography (FA) reveals localized capillary nonperfusion in the affected quadrant, indicating retinal ischemia. Despite the absence of symptoms, close follow-up is essential to monitor for neovascular complications.

Proliferative diabetic retinopathy

Ricardo Leitão Guerra, MD

38yo

In proliferative diabetic retinopathy (PDR), neovascularization elsewhere (NVE) refers to abnormal blood vessel growth in the midperiphery or periphery of the retina. The green channel enhances contrast, making NVE more visible against the retinal background. Identifying NVE early is crucial for guiding treatment, such as panretinal photocoagulation (PRP) or anti-VEGF therapy, to prevent complications like vitreous hemorrhage.

Proliferative Diabetic Retinopathy

Ricardo Leitão Guerra, MD

38yo

In proliferative diabetic retinopathy (PDR), subhyaloid hemorrhage results from fragile neovascularization bleeding into the preretinal space. The green channel enhances contrast, improving hemorrhage visualization on fundus imaging. Optical Coherence Tomography (OCT) shows a well-demarcated, hyperreflective hemorrhagic pocket between the retina and the posterior hyaloid face, which can affect visual acuity depending on its location.