This structure is in the right eye, but not in the left. This is from yesterday. Notice the seeming circle around it? That should be the macula. What is that dark star shape sitting on what looks like a circular circuit board with little transistors? That may be the fovia, but why is it so different in the left and right eyes?
This above is the left eye fovia for comparison. This one also has a circular area, looks like connectors to it. All of this might be just the mind reading into the visual artifacts. Higher resolution images would help.
This looks unnatrual to me, but I’m not a doctor. What is it? Here are some images from a few days before with a different machine:
My vision has been pretty good most of my life, but it sucks now. My left eye has a crap load of floaters and I can see my eye veins almost all of the time. I have to always look through the vein shadows at everything now. It’s annoying as hell.
Today, 9/17/2024, an opthamologist (MD) said he’s never seen Lyme in an eye and they don’t see it here. On the East coast, yes. He said with Lyme you’d likely see optic neuritis, and uvitis but my eyes don’t have that. This last two doctors one Kaiser, one not, said my eyes show no signs of inflammation, edema, or pallor (damage).
As to the mysterious clump of blood cells in my eye three years ago, my main eye doctor said today that lyme disease was unlikely to cause that, it was a vascular hemhorrage that has since healed. As to my seeing afterimages of whatever is in my fovias constantly, he said that the hemhorrage may have left some permanent damage, that was possible.
He confirmed that the vitrious humor pulling away from the retina is what causes floater and they always occur in the back of the eye. He said they never get better or go away, the floaters. Another eye doctor said lasers can break them up into smaller bits, but it risky and the outcomes are not great. There is supposedly a supplement that actually worked in double blind placebo controlled study to reduce the experience of floaters. I need to do a deep dive on that. Floater article coming up, if I can stand looking at the screen long enough.
The Marcular Star Ignored
Why I asked my Kaiser opthamologist what the image was, is that the fovia? He said it could be. Had he ever seen a Macular star? Did he rule that out? This image on the left which seems to match what is in my left eye. It is called a macular star formation. I had to find this myself. A macular star is primarily indicated by the lines radiating out from a center point, but in this case I have an actual gold star type star shape that matches this one in a macular star.
The presence of a macular star could be consistent with a neuroretinitis. Look at mine again. I mean wow man. What the heck? Are you telling me this is not the same thing? Looks like a macular star to me.
“Theodor Leber first described neuroretinitis in 1916, and the name ‘stellate maculopathy’ was coined. As this term denotes, the original site of pathology was thought to be in the macula. However, a subsequent study showed that the fluid leakage at the optic disc precedes the macular star, affecting the macula secondarily. Thus, the term neuroretinitis was born.”[16]
Macular star may be observed in vascular disorders, toxoplasmosis, syphilis, tuberculosis, Lyme disease, and viral infection. Macular star formation is a distinctive retinal finding often associated with various conditions, particularly those involving vascular disorders and infections. The macular star appears as a star-shaped pattern of exudates in the macula and is typically seen in the context of optic disc edema.
Conditions Associated with Macular Star
1. Neuroretinitis:
This is one of the most common conditions associated with macular stars. It can be idiopathic or secondary to infections such as cat-scratch disease, syphilis, toxoplasmosis, and Lyme disease. Neuroretinitis usually presents with unilateral vision loss, optic disc swelling, and the characteristic macular star that may develop 1 to 2 weeks after the onset of symptoms[1][3][6].
2. Infectious Diseases:
– Toxoplasmosis: Often linked to immunocompromised states, it can cause retinal inflammation leading to macular star formation.
– Syphilis: This sexually transmitted infection can lead to ocular complications including neuroretinitis characterized by macular stars[4][6].
– Tuberculosis: Ocular tuberculosis can also manifest with similar retinal findings.
– Lyme Disease: This tick-borne illness has been documented to cause neuroretinitis with associated macular stars[3]. It is known in the medical literature that Lyme disease can lead to neuroretinitis, which may present with macular star findings[13][14][15][16].
3. Other Vascular Disorders:
Conditions such as hypertensive retinopathy and diabetic papillopathy may also result in optic disc swelling and subsequent macular star formation, although these are less common compared to infectious causes[1][2].
Note that for Lyme disease, the first reference says, “Tests for antinuclear antibodies, rheumatoid factor, syphilis, toxoplasmosis, and Lyme disease were negative. Results of chest radiography were normal.” As we have seen from previous research, however, ordinary Lyme tests when the disease reaches the late dissemenated stage are typically negative because the bacteria has a tropism for nervous tissue[9][10] and is not found in the blood. It also knocks out immune cells that would normally cause the positive reaction to it[10][11]. It is not easily detected by PCR because it hides inside of cells and shuffles its outer surface proteins to evade detection[9][12].
Pathophysiology
The mechanism behind the formation of a macular star generally involves increased vascular permeability leading to the leakage of lipids and proteins from the optic disc into the surrounding retinal layers. This process can result from both direct infectious processes and autoimmune responses[1][4].
Clinical Significance
The presence of a macular star is a crucial diagnostic sign that can guide clinicians in identifying underlying conditions that may require specific treatments. For instance, if an infectious cause is identified, appropriate antibiotic therapy may be initiated, while idiopathic cases often resolve spontaneously without treatment[3][5].
In summary, macular stars are significant clinical findings that can indicate various underlying conditions, primarily neuroretinitis due to infectious agents like syphilis and Lyme disease, as well as other vascular disorders.
Citations
[1] https://www.ncbi.nlm.nih.gov/books/NBK570627/
[2] https://eyewiki.org/Neuroretinitis
[3] https://www.aafp.org/pubs/afp/issues/2005/1215/p2517.html
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6849471/
[5] https://eyerounds.org/atlas/pages/Neuroretinitis/index.htm
[6] https://www.sciencedirect.com/science/article/abs/pii/S0025619611646971
[7] https://www.mayoclinicproceedings.org/article/S0025-6196%2811%2964697-1/abstract
[8] https://www.sciencedirect.com/science/article/pii/S2049080122002515
[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8001052/
[10] https://www.hopkinsmedicine.org/news/newsroom/news-releases/2020/12/research-story-tip
[11] https://www.ucdavis.edu/news/lyme-disease-subverts-immune-system-prevents-future-protection
[12] https://pubmed.ncbi.nlm.nih.gov/33801255/
[13] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5426134/
[14] https://athenaeum.uiw.edu/cgi/viewcontent.cgi?article=1063&context=optometric_clinical_practice
[15] https://eyewiki.org/Lyme_Disease
[16] https://www.ncbi.nlm.nih.gov/books/NBK570627/
[17] https://pubmed.ncbi.nlm.nih.gov/73251/
