Case 3-11- Serous Detachment of the Retinal Pigment Epithelium

Clinical Summary

A 70-year-old woman had a large serous detachment of the retinal pigment epithelium in her right eye associated with the clinical diagnosis of age-related macular degeneration (A). Her visual acuity in this eye was 20/ 400. Fluorescein angiography (B) displayed a plaqoid region of hyperfluorescence nasal to the fovea consistent with a neovascujar membrane, and a large area of relative hyperfluorescence involving the macula corresponding to the pigment epithelial detachment.

Optical Coherence Tomography

OCT examination (C) demonstrated a large elevation of the retina and retinal pigment epithelium above an optically clear space. The reflections from the choroid beneath the detachment were attenuated due to shadowing from the highly reflective, detached pigment epithelium, A small pocket of subretinal fluid accumulation was noted temporal to the pigment epithelial detachment. The reflections from the nasal retinal pigment epithelium and choriocapillaris appeared thicker than those at the temporal margin of the image consistent with the leakage pattern of fluorescein dye observed clinically

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