Case 8-29* Choroidal Neovascularization

Clinical Summary

An 80-year-old man was referred for evaluation of age-related macular degeneration and choroidal neovascularization in his left eye, associated with a visual acuity of counting fingers. A pigment epithelial detachment in the macula with a central area of subretinal hemorrhage was described on slit-lamp examination (A). Fluorescein angiography (B) showed central hypofluorescence corresponding to the hemorrhage with a surrounding border of hyperfluorescence, A small region of hyperfluorescence was evident within this lesion which increased in intensity during later phases of the angiogram consistent with choroidal neovascularization.

Optical Coherence Tomography

An OCT scan (C) taken directly through the fovea demonstrated increased retinal thickness in the macula with reduced optical reflectivity consistent with intraretinal fluid accumulation. The reflective band corresponding to the retinal pigment epithelium and choriocapillaris was thickened in a fusiform manner and disrupted directly beneath the fovea suggesting a well-defined choroidal neo-vascular membrane in that area.

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