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Case 12-16, Inferior Seidel Scotoma due to Chorioretinal Scar

Clinical Summary

A 87-year-old white female glaucoma suspect had age-related macular degeneration associated with a visual acuity of 20/30 in her right eye. She had previously received laser photocoagulation treatment for choroidal neovascularization in this eye. On examination, her intraocular pressure was 21 mm Hg. Slit-lamp observation was remarkable only for an intraocular lens implant. Dilated ophthalmoscopy (A, B) revealed marked cupping of the optic disc with an intact neuroretinal rim, and a chorioretinal scar in the superotemporal arcade, A Goldmann visual field iD) displayed an inferior Seidel scotoma.

Optical Coherence Tomography

A circular OCT image (E) acquired around the optic disc at a diameter of 3,4 mm showed a healthy superior nerve fiber layer and only slight atrophy inferiorly. The lack of nerve fiber layer thinning superiorly suggested that the visual field defect was due to the chorioretinal scar and not to a glaucomatous process.

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