Retina

Case 62

Patient Presentation: A 68-year-old female presented to a tertiary retina clinic with vision loss in the right eye for the last 2-weeks. She denied flashes, floaters or recent head trauma. Her past medical or ocular history was unremarkable; however, she was a 30-year-pack smoker. Best-corrected distance visual acuity was 20/100 OD and 20/30 OS with intraocular pressure 13 OD and 14 OS. Fundus examination demonstrated yellow deposits throughout the macula OU with an elevated peripapillary region OD. Fundus photo and OCT macula OD are shown below. 

R62_1.png
R62_2.png

Question: What findings are not present in the OCT above?

The fundus photo and OCT macula of the left eye is shown below:

R62_4.png
R62_5.png

Question: What is the main finding of the OCT above?

The patient elected for treatment of her right eye. Below is the fundus photo and OCT image one month after initial presentation.

R62_6.png

Question: What change is appreciated in the OCT above?

Question: What treatment was initiated in this patient?

Unfortunately, the patient was lost to follow-up aft. She returned to the retina clinic 1 year after her last follow-up complaining of decreased vision OD. Her BCVA was 20/100 OD and 20/30 OS. Fundus examination and OCT imaging of the right eye is shown below:

R62_8.png

Question: What is not appreciated in the OCT macula above?

Learning Objectives:

  1. To investigate the presenting features on fundus examination and OCT of neovascular age-related macular degeneration

  2. Diagnosing type 3 CNMVs

  3. To diagnose pre-choroidal clefts and understand the significance of this OCT finding