1. Ocular Images Issue 1

2. Arcuate scotoma
Arcuate scotoma, extending in superior nasal and superior temporal quadrants. Damage of superior or/and inferior nerve fiber bundle appears as arcuate scotoma in superior or/and inferior visual field. Focal loss appears as paracentral scotomas, arcs or nasal steps. Prolonged sparing of papilomacular bundle preserves the central vision.
Source : Loreta Kuzmiene. Chapter 16. Visual Field Loss in Glaucoma. I. Januleviciene, A. Harris (eds.), Biophysical Properties in Glaucoma, Springer Nature Switzerland AG

3. OCT scan showing RNFL thickness map
This is a good quality OCT scan (Cirrus HD-OCT) with SS value of 8 OD and 9 OS; there are no artifacts or anatomical variations. The RNFL thickness map shows that the inferior RNFL bundle is thinner than the superior bundle in the right eye and compared with the inferior bundle of the left eye (see TSNIT curves). Although the average RNFL thickness measurements are still in the normal range in both eyes, there is an inferior RNFL defect on the RNFL deviation map (black arrowhead). The TSNIT plot and clock hour graphs also demonstrate this defect at the 6 o’clock position. The only abnormal finding among ONH parameters is the cup volume in the right eye, which is borderline abnormal.
Source: Ahmet Akman. Chapter 7. Examples of Optical Coherence Tomography Findings in Glaucoma Eyes with Varying Stages of Severity
A. Akman et al. (eds.), Optical Coherence Tomography in Glaucoma, © Springer International Publishing AG, part of Springer Nature

4. A 64-year-old woman with ocular hypertension
64-year-old woman was diagnosed with ocular hypertension OS. The IOP was 35 mm Hg.
On external examination, prominent sentinel vessels and episcleral pigmentation were noted superiorly.
The anterior segment appeared normal.
On gonioscopy there was diffuse pigment seeding in the angle (arrows)
There is an area of tumor extension from 12 to 1 O’clock meridian.
Ophthalmoscopy revealed peripheral choroidal melanoma (arrows).
Ciliary body and angle extension were confirmed by ultrasound biomicroscopy (arrows)
Source: Reena Garg, Annapurna Singh, and Arun D. Singh. Tumor-Associated Glaucoma A. D. Singh, B. E. Damato (eds.), Clinical Ophthalmic Oncology, © Springer Nature Switzerland AG 2019.

5. Tumor associated glaucoma
a) Diffuse iris melanoma of the lower half of the iris causing secondary glaucoma (IOP = 26 mm Hg).
b) Gonioscopy confirmed pigment seeding in the angle.
Source: Reena Garg, Annapurna Singh, and Arun D. Singh. Tumor-Associated Glaucoma. A. D. Singh, B. E. Damato (eds.), Clinical Ophthalmic Oncology, © Springer Nature Switzerland AG 2019.

6. Intravitreal triamcinolone
A 64-year-old man with a history of pars planitis in his right eye complained of blurred vision. His visual acuity is 20/50 due to cystoid macular edema. He was treated with an intravitreal injection of triamcinolone acetonide.
a) Color fundus photograph shows white crystals of triamcinolone.
b) A longitudinal inferior ultrasound B-scan displays intravitreal triamcinolone acetonide as a hyperreflective deposit (white arrow).
c) Following treatment, the visual acuity improved to 20/32.
Source: Abdulrahman H. Algaeed and Igor Kozak. Miscellaneous Cases .H. Algaeed, I. Kozak (eds.), Clinical Atlas of Ophthalmic Ultrasound, Springer Nature Switzerland AG 2019.

7. Behçet’s disease: acute retinal detachment
A 29-year-old man with a history of Behçet’s disease presented with vitritis and hand-motion vision in his left eye.
A longitudinal inferotemporal ultrasound B-scan shows a shallow retinal detachment (white arrow) and vitreous debris.
A longitudinal inferior ultrasound B- scan of the same eye shows a shallow retinal detachment (white arrow) and some vitritis
Source: Abdulrahman H. Algaeed and Igor Kozak. Miscellaneous Cases. A. H. Algaeed, I. Kozak (eds.), Clinical Atlas of Ophthalmic Ultrasound, © Springer Nature Switzerland AG 2019

8. Eye burn by low concentration alkali
A 43-year-old male visited us 1 h after the right eye was injured with low-concentration alkali solution and washed immediately with a lot of clear water. The visual acuity was finger counting at 10 cm.
A transverse zonal corneal opacity located in the superficial layer
On day 1 after amniotic membrane transplantation
The clear cornea after amniotic membrane removal
Source: Weiyun Shi and Ting Wang. Ocular Chemical Burns. H. Yan (ed.), Atlas of Ocular Trauma, Ocular Trauma, . © Springer Nature Singapore Pte Ltd. 2019

9. Leukocoria
Leukocoria due to cataract induced by a chronic retinal detachment. An abnormal pupil reflex is also frequently observed in several pediatric ocular conditions including cataract, and it is important to clinically differentiate retinoblastoma from simulating diagnoses.
Source: Jonathan W. Kim and Arun D. Singh. Differential Diagnosis of Leukocoria. J. L. Berry et al. (eds.), Clinical Ophthalmic Oncology, © Springer Nature Switzerland AG 2019

10. Retinoblastoma
Anterior segment involvement by retinoblastoma presenting as neovascular glaucoma (a) due to large tumor filling the entire globe on the MRI (b). Eventually due to raised intraocular pressure, buphthalmos can develop evident as asymmetric globes on external examination (c) and the MRI (d).
Source: Jonathan W. Kim and Arun D. Singh. Differential Diagnosis of Leukocoria. J. L. Berry et al. (eds.), Clinical Ophthalmic Oncology, © Springer Nature Switzerland AG 2019

11. Persistent hyperplastic primary vitreous
Persistent hyperplastic primary vitreous/ persistent fetal vasculature.
a. A 3-month-old boy with left leukocoria and microphthalmos.
b. Fundus appearance of the right eye was normal.
c. In the left eye, retrolental fibrovascular proliferation with central dragging of ciliary processes is evident.
d. On B-scan, persistent hyaloid remnants arising from the optic nerve simulating a tightly closed, funnel- shaped retinal detachment is present.
Source: Jonathan W. Kim and Arun D. Singh. Differential Diagnosis of Leukocoria. J. L. Berry et al. (eds.), Clinical Ophthalmic Oncology, © Springer Nature Switzerland AG 2019

12. En face solar retinopathy
En face image of photoreceptor damage from solar retinopathy (sungazing).
Top panel: en face slab of the so-called ellipsoid zone (EZ)-band, generated from the macular cube scan. Inset shows the absent signal in the fovea, indicating loss of the EZ-band (red arrows).
Middle panel – OCT B-scan through the fovea. The foveal external limiting membrane is intact (higher green arrow), but there is a hyporeflective space where the inner and outer segments should be (lower red arrows).
Bottom panel – OCT B-scan through the fovea. Dotted purple lines immediately anterior to the retinal pigment epithelium show the upper and lower boundaries of the slab used to generate the en face image in the top panel.
Source: Phuc V. Le. Posterior Uveitis: Role of Imaging Modalities. N. A. Rao et al. (eds.), Posterior Uveitis, Essentials in Ophthalmology, © Springer Nature Switzerland AG 2019

13. Thyroid Eye Disease
Clinical picture showing right proptosis, soft tissue signs, right hypotropia and limitation of right eye movements in up and left gazes.
Source: Shantha Amrith, Stephanie Ming Young, Poh Sun Goh, et al. Thyroid Eye Disease. S. Amrith et al. (eds.), Ocular Adnexal Lesions, © Springer Nature Singapore Pte Ltd. 2019

14. Thyroid Eye Disease (cont’d)
Clockwise from the top left:
Coronal T1w MRI with contrast shows enlarged enhancing right inferior rectus muscle (arrow).
Coronal T1w MRI with contrast showing diffuse enhancement of right intraconal fat (arrow).
Axial T1w MRI with contrast shows enlarged right inferior rectus with enhancement in Tenon’s capsule indicating inflammation.
Axial contrast-enhanced CT showing similar enlargement of right inferior rectus and proptosis of the right eye.
Sagittal contrast-enhanced CT shows tendon- sparing enlargement of inferior rectus (arrow) .
Source: Shantha Amrith, Stephanie Ming Young, Poh Sun Goh, et al. Thyroid Eye Disease. S. Amrith et al. (eds.), Ocular Adnexal Lesions, © Springer Nature Singapore Pte Ltd. 2019