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Case 8-46, Juxtapapillary Choroidal Neovascularization and Macular Pseudohole

Clinical Summary

A 63-year-old man with a history of uveitis was evaluated for a temporal visual field defect in his left eye. His visual acuity in that eye was 20/20. Slit-lamp ophthalmoscopy (A) indicated a well-defined region of gray discoloration and mild retinal elevation temporal to t ie optic disc consistent with subretinal neovascularization. A focal spot of subretinal hemorrhage was also seen inferotemporal to the disc- The discoloration and thickening did not involve the fovea! center; however, a macular pseudohole was noted in the fovea. Fluorescein angiography (B) revealed an irregular, hyperfluorescent lesion temporal to the disc which gradually increased in intensity in the later phases of the study. Mild late leakage of dye from the lesion was also visible

A horizontal OCT tomogram (C; white line on A) obtained through the optic disc displayed a well-defined, juxtapapillary region of enhanced backscatter signal in the posterior retina corresponding to the neovascularization observed clinically. A vertical image (D; black line on A) was also acquired through the macula. The contour of the foveal pit was steepened consistent with an epiretinal membrane and an associated macular pseudohole. The epiretinal membrane was visible only where it was separated from the neurosensory retina (arrow).

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