Ophtho On Call Case 8: Case Continued…

Ophtho On Call Case 8 Index

Answer: An OCT will be helpful to evaluate for presence of macular edema and flourescein angiography (FA) can help to identify areas of non-perfusion from ischemic vasculopathies of the retina. An OCT of the RNFL may show thickening if there is optic nerve involvement but would not be necessary to obtain unless and primary optic neuropathy was suspected. 

OCT Macula and FA of the left eye are shown below:


Above Image courtesy of Jeanette Du, MD

OCT macula shows diffuse thickening of the retina with cystoid macular edema and FA of demonstrates diffuse leakage with areas of peripheral nonperfusion.

What are the best next steps? Click all that apply
Counsel patient on optimizing blood pressure and blood sugar control (ie diet, exercise, medications)
Administer intravitreal anti-VEGF
Initiate stroke protocol
Perform temporal artery biopsy

Click here to move on!

Ophtho On Call Case 8 Index
Ophtho On Call Case 8: Introduction
Ophtho On Call Case 8: Additional History & Physical Exam