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    General

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    Grand Rounds

    A patient with a history of myopia presented with blurred vision in one eye and was diagnosed with central serous chorioretinopathy at an outside facility. The patient denied systemic illness or medication use. Fundus examination revealed subtle yellowish subfoveal changes, while OCT demonstrated subretinal hyperreflective material with outer retinal disruption and choroidal hypo-transmission, suggestive of possible neovascular activity. Fluorescein angiography showed early focal hyperfluorescence with late leakage, and indocyanine green angiography revealed corresponding hypofluorescent areas. Fundus autofluorescence displayed hypoautofluorescent spots bordered by hyperautofluorescent rims, and OCT angiography confirmed a neovascular network at the outer retina–choriocapillaris interface. Infectious and systemic inflammatory causes were excluded, establishing the diagnosis of punctate inner choroidopathy complicated by secondary CNV. The patient was treated with a single intravitreal injection of bevacizumab, resulting in resolution of subretinal fluid and restoration of foveal contour within two weeks. This case underscores the importance of multimodal imaging in distinguishing inflammatory CNV from CSC and idiopathic CNV in young myopic patients, highlighting that early anti-VEGF therapy can effectively preserve vision and prevent irreversible subfoveal fibrosis.

    Presentation Date: 10/30/2026
    Issue Date: 07/03/2026