Case 8-24, Fibrovascular Pigment Epithelial Detachment

Clinical Summary

A 75-year-old woman had a visual acuity of counting fingers in her right eye associated with age-related macular degeneration. Dilated ophthalmoscopy (A) showed an eleva ted, moderately pigmented fibrovascular detachment of the retinal pigment epithelium in the central macula. Fluorescein angiography (B) showed a well-defined hyperfluorescent lesion centrally which demonstrated leakage of dye as the angiogram progressed consistent with well-defined choroidal neovascularization.

Optical Coherence Tomography

An elevation of the neurosensory retina and retinal pigment epithelium (RPE) was observed on a horizontal OCT tomogram (C) acquired through the detachment. The reflection from the RPE was abnormally thickened and not well defined beneath the lesion. Moderate optical back-scatter was noted extending from the detached RPE into the choroid consistent with fibrovascular proliferation.

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