Macular Degeneration

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Case 8-12, Serous Detachment of the Retinal Pigment Epithelium

Clinical Summary

74-year-old woman with age-related macular degeneration noted a decline in her visual acuity to 20/70 and metamorphopsia in her right eye over the past four to five months, Dilated fundus examination (A) showed a serous pigment epithelial detachment in the central macula. Progressive filling of the detachment was noted on fluorescein angiography (B), Poorly defined hyperfluorescence associated with mild late leakage was also observed inferior and inferotemporal to the fovea.

Optical Coherence Tomography

A vertical OCT tomogram (C) taken through the detachment showed an elevation of the pigment epithelium over an optically clear space corresponding to serous fluid accumulation. The reflection from the choroid below the detachment was attenuated. There was an increase in the thickness of the red band defining the posterior boundary of the neurosensory retina at the inferior margin of the detachment consistent with possible choroidal neovascularization.

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