Grand Rounds
A 68-year-old female with nonexudative AMD in both eyes, presents with new visual distortion in her left eye. Clinical exam shows markedly declined visual acuity, fundus examination shows small punctate extrafoveal hemorrhage in the left eye. SD-OCT shows a hyperreflective focus (HRF) in the outer retinal capillary layer, adjacent cystoid maculopathy and pigment migration overlying a pigment epithelial detachment (PED). OCT Angiography shows retinal thickening, the total retina and avascular slab show a bright signal intensity on en face angio and the corresponding B scan, show retinal flow in the area of the HRF, characteristic of Type 3 MNV. Prior OCT Angiography showed high risk characteristics and was monitored closely. She received intravitreal Avastin in the left eye. Following 3 monthly injections of intravitreal Avastin, the cystoid maculopathy resolved, and the size of the PED decreased with dramatic improvement in visual acuity. Patient was scheduled for follow up in 6 weeks on a TAE regimen.
Presentation Date: 05/28/2020
Issue Date: 08/01/2020
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