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Case 55

Patient Presentation: A 79-year-old female presented to a retina clinic for assessment of her known dry age-related macular degeneration. She noted 6 months of progressively worsening vision OD. She denied alternative past ocular history; she noted a past medical history of hypertension and dyslipidemia. She was using Vitalux daily. 

Her vision was 20/50 OD and 20/20 OS with intraocular pressures within normal limits. Her pupils were equal and reactive to light. Anterior segment examination was unremarkable. Fundus examination found soft drusen in the macula bilaterally, as well as a blunted foveal reflex OD. A macula cube OCT was conducted and shown below:


Question: What is not appreciated in the above OCT?

Question: What is the significance of hyper-reflective material?

Due to the presence of the SHRM and fibrovascular PED on OCT, OCT angiography was conducted and shown below:


Question: What can be appreciated in the OCTA above?

Learning Objectives:

  1. Clinical importance of subretinal hyper-reflective material.

  2. Differentiating different types of choroidal neovascularization membranes

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