1. Doheny Eye Institute Grand Rounds Presenter Irina Bykhovskaya, MD Discussant Dr. SriniVas Sadda 3/9/2007

3. Fundus Photos lipid-rich, yellow subretinal exudate in the posterior pole OS

4. Fundus Photos OS

5. Red-Free Fundus Photos

6. Fluorescein Angiogram

7. Fluorescein Angiogram

14. Histopathology Loss of vascular endothelium and pericytes All levels of the retinal vascular circuit are involved Proteinaceous subretinal exudates with prominent cholesterol clefts and prominent histiocytes Total exudative retinal detachment

15. Histopathology cont’d Subretinal fluid with cholesterol clefts and lipid-laden macrophages Telangiectasic retinal vessels Intraretinal cholesterol deposition triggering a giant cell reaction foreign-body type