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Patient Presentation: A 23-year-old obese female was diagnosed with idiopathic intracranial hypertension (IIH) and referred to neurosurgery for ventriculoperitoneal shunt. A baseline ocular examination was performed prior to the procedure.
On examination, vision was 20/200 in the right eye, and 20/40 in the left eye. There was a right relative afferent pupillary defect. Slit lamp examination was normal.
A dilated fundus examination was performed demonstrating the following:
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Retina
Case 44
Patient Presentation: A 23-year-old female was referred to a tertiary retina clinic for assessment of progressively worsening vision for the last 3-months OS. She denied past medical or ocular history. Vision was 20/20 OD and 20/40 OS with no RAPD and IOP within normal limits. Slit lamp examination was unremarkable. Dilated fundus examination was normal OD, but demonstrated macular RPE changes OS. The OCT macula is shown below.
Question: What is the primary finding on the OCT macula above?
Question: What disease process is focal choroidal excavation linked to?
Three weeks later, the patient presented with worsening vision OS. A repeat OCT macula was performed and demonstrated below.
To better characterize the hyper-reflective foci at the FCE, an OCT-angiography was conducted. The outer retina/choriocapillaris segment with accompanying flow B-scan is shown below.
Question: What is the key finding in the above OCTA?
Question: What is the current treatment for CNVM secondary to FCE?
Learning Objectives:
1. The presentation, etiology, complication and treatment of focal choroidal excavation.
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