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Case 8-9. Neurosensory and Pigment Epithelial Retinal Detachment

Clinical Summary

A 70-year-old-man with age-related macular degeneration had probable choroidal neovascularization in his left eve associated with a visual acuity of 20/300. A large neurosensory detachment was observed (A) in the central

macula and along the inferior vascular arcade. No hemorrhage was visible and there was minimal exudate- Fluorescein angiography (B) showed mottled hyper fluorescence in the superior macula which increased in intensity as the angiogram progressed. A surrounding hv per fluorescent ring was also observed which demonstrated significant leakage in the late frames.

Optical Coherence Tomography

A horizontal OCT tomogram (C) was acquired through the fovea, A neurosensory detachment was observed directly in the fovea above an optically clear space corresponding to subretinal serous fluid. I wo elevations of the retinal pigment epithelium were visible nasal and temporal to the neurosensory detachment, consistent with the hyperfluorescent ring observed on angiography. The reflective band corresponding to the pigment epithelium appeared intact throughout the image.

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