Case 29

Patient Presentation: A 35 year old healthy female presented to the eye clinic with decreased vision in her left eye x 3 days. Her past ocular history was significant for myopia. She denied any recent ocular trauma.

On examination, vision was 20/20 in the right eye and 20/60 in the left eye. There was no relative afferent pupillary defect and she had normal intraocular pressures. Slit lamp examination was normal. Dilated fundus examination demonstrated peri-papillary atrophy and tilted nerves in both eyes. An OCT macula was performed in both eyes, shown below:

Question: Which of the following material does NOT appear hyper-reflective on OCT?

Question: Please describe the OCT of the left eye:

Question: Based on the clinical presentation and the OCT, what is the most likely diagnosis?

Question: Which of the following can be used in the treatment of mCNVM?

The patient in our case was treated with intravitreal anti-VEGF agent, and a repeat OCT was performed one month later, shown to the left. Notice that the sub-retinal hyper-reflective lesion has shrunken in size after treatment.  

Learning Objectives:

1. To review the OCT features of myopic CNVM

2. To understand the OCT parameters in evaluating mCNVM activity

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