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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.

Retina 44-1.png

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.

Retina 44-3.png

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.

Retina 44-4.png

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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