Macular Degeneration

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Case 8*21 continued

Clinical Summary

The patient experienced an even more rapid decline in vision in her left eye, with her visual acuity in this eye reaching 20/400 over a period of four months, Slit-lamp examination (D) showed a fibrovascular pigment epithelial detachment in the central macula and a serous pigment epithelial detachment superotemporal to the fovea. Neovascularization of the optic disc was also observed associated with evidence of partial occlusion of the superotemporal branch vein. Fluorescein angiography (E) confirmed pooling of dye within the serous pigment epithelial detachment Several other regions of mild hyper-fluorescence were observed surrounding the fovea. The superotemporal branch arteriole and vein exhibited delayed filling.

Optical Coherence Tomography

A vertical OCT image (F) taken through the fibrovas-cuiar pigment epithelial detachment showed an elevation of the red band corresponding to the RPE with moderate optical backscatter below consistent with fibrovascular proliferation. The reflection from the RPE was attenuated and fragmented through the inferior margin of the lesion. Non-reflective cystic spaces were identified in the fovea.

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