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JAMA Ophthalmology Clinical Challenge |

Retinal Rings QUIZ

Peter M. Lipscomb, MD1; Ashvini K. Reddy, MD2
[+] Author Affiliations
1Department of Ophthalmology, University of Virginia, Charlottesville
2Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
JAMA Ophthalmol. 2016;134(4):459-460. doi:10.1001/jamaophthalmol.2015.3646.
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A woman in her early 80s with a history of systemic hypertension and heart failure presents with retinal changes, including an annular area of hypopigmentation, in both eyes. What would you do next?

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A, Fundus photograph of the right eye shows poor foveal light reflex, an annular pattern of outer retinal hypopigmentation approximating the border of the temporal arcade, and inferotemporal clumped pigment deposits (seen in both eyes). B, Spectral-domain optical coherence tomographic (SD-OCT) image of the right eye shows outer retinal foveoschisis and outer retinal thinning with interruptions of the ellipsoid in the peripheral macula (seen in both eyes). C, Fluorescein angiogram at 1 minute 15 seconds in the right eye shows no disc leakage or angiographic macular edema; there is faint staining of the annular area of hypopigmentation seen on the fundus photograph.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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