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JAMA Ophthalmology Clinical Challenge
November 23, 2016

Dark Retinal Lesion in a Young Asymptomatic Man

Author Affiliations
  • 1Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago
JAMA Ophthalmol. Published online November 23, 2016. doi:10.1001/jamaophthalmol.2016.2839

A visually asymptomatic Hispanic man in his early 20s was referred to the vitreoretinal clinic for a posterior segment abnormality in his left eye found on routine ocular examination. The patient recalled that the lesion was initially discovered 4 years prior to presentation at a different facility. He denied any previous ocular trauma and his medical and surgical histories were noncontributory. Results of a complete review of systems were otherwise negative.

At presentation, his visual acuity was 20/20 OU. Pupils and extraocular motility were intact. Intraocular pressures were 11 mm Hg OU. The anterior segment slitlamp examination was unremarkable in both eyes. A dilated retinal examination of the left eye revealed the findings depicted in the Figure, A. No retinal traction was noted. Spectral-domain optical coherence tomography was subsequently performed (Figure, B). No retinal pigment epithelium (RPE) atrophy, macular edema, retinal exudation, or subretinal fluid was noted. Posterior segment examination and imaging of the right eye demonstrated no abnormalities.

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