Case 8-27, Subretinal Hemorrhage and Thrombus

Clinical Summary

A 74-year-old man with the clinical diagnosis of age-related macular degeneration had a sub-macular hemorrhage in His left eye associated with a visual acuity of counting fingers (A), A large hypofluoresecent lesion was present directly in the macula on fluorescein angiography during all phases of the angiogram (B) consistent with hemorrhage. Several areas of relative hyper fluorescence were noted temporal to the fovea.

Optical Coherence Tomography

A vertical tomogram (C) acquired through the fovea showed an elevated macula and a brightly backscattering region directly beneath the fovea. The high reflectivity of this area was consistent with hemorrhage, which attenuated the backscattering signal from the normally bright pigment epithelium and choriocapillaris, An optically clear region of subretinal fluid accumulation was noted immediately inferior to the hemorrhage on the image.

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