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Case 8-42, Choroidal Neovascularization

Clinical Summary

An 83-year-old man with a history of choroidal neovascularization in his right eye complained of new metamor-phopsia in his left eye. On examination, his visual acuity in the left eye was 20/100 and slit-lamp biomicroscopy (A) revealed a low, irregular pigment epithelial detachment with no subretinal fluid, hemorrhage, or exudate. Fluorescein angiography (B) showed a poorly defined region of hyperfluorescence in the central macula which increased in intensity as the study progressed.

Optical Coherence Tomography

A vertical OCT image (C) delineated an irregular thickening (arrows) of the reflective layer corresponding to the retinal pigment epithelium and choriocapillaris directly beneath the fovea consistent with subretinal neovascularization. An optically clear space of subretinal fluid accumulation was observed immediately inferior this lesion. There was minimal thickening of the overlying neurosensory retina.

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