CE Event Recap: Masquerades in Retinal Diseases
On December 12, 2023, Retina Consultants of Texas presented a virtual CE webinar entitled, “A Night at the Ball: Masquerades in Retinal Disease.” Hosted by Dr. James C. Major, the webinar reviewed several cases that initially presented as one condition, but ended up being something else. The webinar was split into two presentations by Dr. Patrick Staropoli and Dr. Hasenin Al-khersan, two of RCTX’s newest retina specialists in the greater Houston area
Dr. Staropoli’s Presentation
Dr. Staropoli kicked off the night by discussing a case of a patient experiencing light sensitivity after an uncomplicated cataract surgery caused by post-surgery inflammation. Initially, the patient was diagnosed with toxic anterior segment syndrome (TASS), however, it was later determined that the patient had endophthalmitis.
Dr. Staropoli used the case to extensively discuss how endophthalmitis can mask itself as other conditions, including TASS, retained lens fragmentation, uveitis glaucoma hyphema (UGH) syndrome, and uveitis, as well as non-infectious causes, such as a recent intravitreal steroid injection. He finished his presentation by focusing on the diagnosis and treatments that are currently in development for infectious intraocular conditions, including next-generation sequencing (NGS).
Dr. Al-khersan’s Presentation
Dr. Al-khersan’s presentation centered on a “snake in the grass” case, in which a patient initially presented with decreased vision in the left eye and symptoms were consistent with age-related macular degeneration (AMD). She was originally diagnosed with peripapillary choroidal neovascular membrane (CNVM), which appeared to improve after treatment with injections. However, four years later, while the original issues had mostly been resolved, there was now subretinal hyper-reflective material and hemorrhaging.
With further investigation using autofluorescence imaging, unusual characteristics were found indicating that the condition was not simply just AMD, including a dramatic expansion of legions, minimal drusen, progressive chorioretinal atrophy, and subretinal fibrosis extending beyond the macula. The patient eventually received a new diagnosis of serpiginous choroiditis, a condition characterized by “snake-like” inflammatory tissue growing on the choroid. Dr. Al-khersan pointed out that there’s a wide spectrum of diseases that can masquerade as AMD, including tuberculosis choroiditis, polypoidal choroidal vasculopathy (PCV), pathologic myopia, presumed ocular histoplasmosis syndrome (POHS), choroidal rupture, and angioid streaks. He also discussed how autofluorescence is an exceptionally useful diagnostic method for differentiating AMD from its masqueraders.
We invite you to watch the full video of our “A Night at the Ball: Masquerades in Retinal Diseases” presentation on our YouTube channel. To attend Retina Consultants of Texas’s next CE Zoom event, please register here for updates.
