Idiopathic Focal Atrophy
This is a montage of images from a 34-year-old man with a central retinal vein occlusion. The acute appearance from 2014 is in the upper right frame (labeled with date). The veins are dilated and there are intraretinal hemorrhages (yellow arrows). By 2019 these changes had resolved, but chronic lipid exudates were present superotemporally. Why the exudates did not accumulate in the macula but did so peripherally is a mystery and is unusual. The teal arrows indicate the lipid exudates. The green circles highlight small residual hemorrhages. The OCT inset at the bottom right shows that the exudates are hyperreflective and associated with cystoid changes of the inner retina.