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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:
Patient Presentation: A 55-year-old male was referred to a tertiary retina clinic by his optometrist for suspicion of dry age-related macular degeneration (AMD) OS. The patient denied any acute change in vision or family history of AMD. Past medical history included hypothyroidism managed with levothyroxine.
Vision was 20/20 OU with no RAPD and IOP within normal limits. Slit lamp examination was unremarkable. Near-infrared reflectance imaging was conducted which demonstrated hyper-reflective foci at the macula surrounding a circular focal area of hypo-reflectance at the fovea OS. Multi-color SLO imaging was conducted which demonstrated multiple red foci surrounding the fovea OS suggestive of depigmentation. Right eye imaging was unremarkable.
Question: What finding is not appreciated in the OS OCT macula above?
Question: Based on the initial OCT macula imaging findings, what disease spectrum is high on your differential diagnosis?
An OCT angiography OS was completed to better characterize the hyper-reflectivity at the level of the RPE:
Question: Based on the OCT-angiography, what entity of PDS is the diagnosis most likely?
Question: What is the mainstay of treatment for pachychoroid neovasculopathy?
1. The presentation, imaging findings and diagnosis of pachychoroid neovasculopathy.
2. Characterizing the various entities of pachychoroid disease spectrum.
3. Treatment of PNV.
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