Rain Cloud Sign- October 2020

The OCT images of a patient who developed endogenous candida endophthalmitis are shown below. Could you describe the OCT finding indicated by a black asterisk and white arrows of this patient?

The answer to the question is ‘’Rain Cloud Sign’’. As a result of the lottery drawn among those who answered the question correctly, Mr. Murat Oklar won this month’s book prize. Congratulations to him.

‘’Rain Cloud Sign’’ is a definition  given to fungal colonies in eyes with endogenous candida endoftlami on OCT imaging. Candida enters the eye through the choroid or retinal vasculature and moves through the vitreous.  Candida colonies appear as white hyperreflective round-shaped lesions (black asterisk) on the retinal surface and vitreous, and highly reflective lesions with shadowing (white arrows). The white hyperreflective lesions and the underlying shadowing are defined as rain cloud signs.

Invernizzi A, Symes R, Miserocchi E, Cozzi M, Cereda M, Fogliato G, Staurenghi G, Cimino L, McCluskey P. SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY FINDINGS IN ENDOGENOUS CANDIDA ENDOPHTHALMITIS AND THEIR CLINICAL RELEVANCE. Retina. 2018;38(5):1011-1018



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