Retina

Case 30

Patient Presentation: A 65 year old Asian female presented to the eye clinic with acute vision loss in her right eye. On examination, vision was 20/400 OD and 20/20 OS. There was no relative afferent pupillary defect and IOP were normal. Slit lamp examination was normal. Fundus examination was performed in the right eye, demonstrating the following:

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Question: Please describe the fundus photograph:

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Question: OCT macula was performed in the right eye, shown to the left. Please describe the OCT macula:

Question: Indocyanine green angiography (ICGA) was performed demonstrating focal hypercyanescent nodules in the sub-RPE space. Given this, what is the likely diagnosis?

Question: The EVEREST trial was conducted to assess the effects of verteporfin photodynamic therapy (PDT) combined with ranibizumab or alone versus ranibizumab monotherapy in patients with symptomatic macular polypoidal choroidal vasculopathy. The EVEREST trial diagnosed PCV based on what criteria?

Question: In a recent study performed by Chaikitmongkol et al. (JAMA 2019), 4 highly suggestive diagnostic features were identified using fundus photos and OCT in diagnosing PCV. What are the four features?

Learning Objectives:

1. To identify the OCT features suggestive of PCV

2. To utilize OCT to identify the location of retinal pathology