A 55-year-old patient with sudden painless vision loss and a media haze precluding fundus view undergoes B-scan ultrasonography. A V-shaped, folded hyperechoic membrane is seen extending from the ora serrata anteriorly to the optic disc posteriorly, with after-movement on dynamic scanning. This finding is diagnostic of:

• A Posterior vitreous detachment
• B Choroidal detachment
• C Vitreous hemorrhage
• D Retinal detachment ✓

Explanation

A V-shaped or funnel-shaped hyperechoic membrane attached from ora serrata to optic disc with after-movement is pathognomonic of total retinal detachment. Posterior vitreous detachment shows a thin, mobile, curvilinear membrane not attached at the ora serrata. Vitreous hemorrhage shows diffuse dot-like opacities. Choroidal detachment shows smooth, dome-shaped, thick membranes without attachment at the optic disc.

Reference: Bowling, Kanski's Clinical Ophthalmology, 8th ed.

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Written and medically reviewed by the StethoPrep medical team.