Case 7

A 25 years old female complained of some diminution of vision in the left eye.
Examination of the posterior segement revealed an upper temporal macular lesion with overlying vitreous haemorrhage.
1st FFA and Ultrasound were done followed by OCT.

FFA report shows an eleveated lesion with SRF with no clear evidence of vessel involvement with overlying hemorrhage and no evidence of retinal mass.

Ultrasound report did not exclude a mass and showed the elevated lesion which was said to be either subretinal serous or hemorrhagic acculumation.

Finally OCT was done and to my surprise it did not show any serous detachment of the retina but a detachment of the ILM and part of NFL, there was total PVD and there was posterior shadowing in some parts by the overlying organized vitreous hemorrhage.

What is the likely diagnosis of this case?
Is there any more confirmatory investigations?
And finally how would it be managed?

Case 2

This case is presented by Consultant Dr. Azza Ismaiel:

The parents of a 7 year old child noticed facial asymmetry since birth. Seeking medical advice, the child was diagnosed as having left facial hypoplasia. U/S done at the age of 3 months gave the diagnosis of left PHPV (persistent hyperplastic primary vitreous). No intervention was done since then. Recently the parents came seeking ophthalmic advice aiming to achieve improvement of visual acuity in the left eye.

Color photo shows a well-defined whitish lesion in front of the disc with ghost vessels along the upper arcade. Another ill-defined whitish lesion was detected in front of the previously described one occupying the posterior vitreous compartment. The macular area could not be evaluated due to uncooperative patient.

U/S shows a lesion arrising from the optic disc that has a highly echogenic surface and heterogenous internal echogenicity.

U/S examination of the nasal retina showing moderately echogenic band extending from the retina to the ora serrata.