Macular Degeneration

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Case 8-10. Neurosensory Detachment with Cloudy Subretinal Fluid

Clinical Summary

A 63-year-old man with age-related macular degeneration noted a gradual decrease in vision in his left eye. He had undergone indocyanine green enhanced diode laser photocoagulation 15 months earlier for choroidal neovascularization- On examination, his visual acuity in this eye was 20/160. Slit-lamp biomicroscopy (A) revealed an atrophic chorioretinal scar superonasal to the fovea and a neurosensory detachment extending inferotemporally passing beneath the fovea. The sub retinal fluid appeared cloudy with mild subretinal fibrosis.

Optical Coherence Tomography

On OCT examination (B), the neurosensory retina was elevated over optically transparent regions of serous fluid accumulation and areas of moderate, subretinal backscat-ter consistent with subretinal fibrosis. The reflection from the pigment epithelium and choriocapillaris was intact below the lesion suggesting the absence of a recurrent neo-vascular membrane. Enhanced reflectivity was observed beneath the neurosensory retina in the area of the chorioretinal scan

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