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61-year-old woman was seen in the office on 3/24/2009. She noticed March 12th, which is about twelve days ago, a spot to the right of her central vision. She was not doing any lifting or straining at the time and was just sitting and reading a magazine. She has noticed, since it came on, that the vision off to the side might be a little less distorted. In July she did have a clot in her left leg when her leg swelled up and she was put on Coumadin for that. She is now approved to go off Coumadin and go on aspirin, but she has not quite made the transition yet. She was a regular blood donor and donated over five gallons. She is not known to have any blood disorder and she has not been anemic. If anything, her iron levels were a little high for awhile because she was taking oral iron. She has good health otherwise. She also has high blood pressure. VISUAL ACUITY: Vision OD is 20/25, OS is 20/25. IOP: OD 15, OS 12. AMSLER GRID: Right eye paracentral metamorphopsia and the left eye is normal. SLIT LAMP EXAM: Normal with clear lenses in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.0. There is a posterior vitreous separation. There are angioid streaks with most of the streaks going nasally, but there is a streak just going off of the optic nerve at 10:00 o’clock. Adjacent to that is a triangular-shaped subretinal choroidal neovascular membrane with hemorrhage around the edges which stops a disc diameter short of the fovea. OS: Vertical C/D ratio is 0.0. There is a posterior vitreous separation. There are, similarly, angioid streaks around the optic nerve and there is one streak which goes just superior to the fovea. IMPRESSION: 1. IDIOPATHIC ANGIOID STREAKS – BOTH EYES 2. SUBRETINAL CHOROIDAL NEOVASCULAR MEMBRANE – RIGHT EYE 3. AGE-RELATED MACULAR DEGENERATION – RIGHT EYE 4. RETINAL HEMORRHAGE – RIGHT EYE DISCUSSION: I explained to the patient unfortunately there is a blood vessel growth in the right eye which, if left alone, has about an 80% chance of severely impairing her central vision. With intravitreal Avastin, we can reduce the risk of vision loss in that eye and probably even facilitate some vision improvement since the Avastin is excellent at shrinking up the blood vessels and drying up the leakage.

angioidcnam_jasc_281429.jpg
Angioid Streaks - New Extrafoveal Choroidal Neovascular Membrane Right Eye162 views61-year-old woman twelve days ago, saw a spot to the right of her central vision. OD is 20/25, OS is 20/25
Treated with one year of avastin with good result and no vision loss.
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angioidcnam_jasc_28029.jpg
Angioid Streaks - New Extrafoveal Choroidal Neovascular Membrane Right Eye99 views61-year-old woman twelve days ago, saw a spot to the right of her central vision. OD is 20/25, OS is 20/25
Treated with one year of avastin with good result and no vision loss.
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(0 votes)
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angioidcnam_jasc_28129.jpg
Angioid Streaks - New Extrafoveal Choroidal Neovascular Membrane Right Eye118 views61-year-old woman twelve days ago, saw a spot to the right of her central vision. OD is 20/25, OS is 20/25
Treated with one year of avastin with good result and no vision loss.
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(0 votes)
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angioidcnam_jasc_28229.jpg
Angioid Streaks - New Extrafoveal Choroidal Neovascular Membrane Right Eye71 views61-year-old woman twelve days ago, saw a spot to the right of her central vision. OD is 20/25, OS is 20/25
Treated with one year of avastin with good result and no vision loss.
00000
(0 votes)
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angioidcnam_jasc_28329.jpg
Angioid Streaks - New Extrafoveal Choroidal Neovascular Membrane Right Eye73 views61-year-old woman twelve days ago, saw a spot to the right of her central vision. OD is 20/25, OS is 20/25
Treated with one year of avastin with good result and no vision loss.
00000
(0 votes)
Add to Favorites
angioidcnam_jasc_28429.jpg
Angioid Streaks - New Extrafoveal Choroidal Neovascular Membrane Right Eye91 views61-year-old woman twelve days ago, saw a spot to the right of her central vision. OD is 20/25, OS is 20/25
Treated with one year of avastin with good result and no vision loss.
00000
(0 votes)
Add to Favorites
angioidcnam_jasc_28529.jpg
Angioid Streaks - New Extrafoveal Choroidal Neovascular Membrane Right Eye68 views61-year-old woman twelve days ago, saw a spot to the right of her central vision. OD is 20/25, OS is 20/25
Treated with one year of avastin with good result and no vision loss.
00000
(0 votes)
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angioidcnam_jasc_28629.jpg
Angioid Streaks - New Extrafoveal Choroidal Neovascular Membrane Right Eye47 views61-year-old woman twelve days ago, saw a spot to the right of her central vision. OD is 20/25, OS is 20/25
Treated with one year of avastin with good result and no vision loss.
00000
(0 votes)
Add to Favorites
angioidcnam_jasc_28729.jpg
Angioid Streaks - New Extrafoveal Choroidal Neovascular Membrane Right Eye39 views61-year-old woman twelve days ago, saw a spot to the right of her central vision. OD is 20/25, OS is 20/25
Treated with one year of avastin with good result and no vision loss.
00000
(0 votes)
Add to Favorites
angioidcnam_jasc_28829.jpg
Angioid Streaks - New Extrafoveal Choroidal Neovascular Membrane Right Eye39 views61-year-old woman twelve days ago, saw a spot to the right of her central vision. OD is 20/25, OS is 20/25
Treated with one year of avastin with good result and no vision loss.
00000
(0 votes)
Add to Favorites
angioidcnam_jasc_28929.jpg
Angioid Streaks - New Extrafoveal Choroidal Neovascular Membrane Right Eye75 views61-year-old woman twelve days ago, saw a spot to the right of her central vision. OD is 20/25, OS is 20/25
Treated with one year of avastin with good result and no vision loss.
00000
(0 votes)
Add to Favorites
angioidcnam_jasc_281029.jpg
Angioid Streaks - New Extrafoveal Choroidal Neovascular Membrane Right Eye71 views61-year-old woman twelve days ago, saw a spot to the right of her central vision. OD is 20/25, OS is 20/2500000
(0 votes)
Add to Favorites
angioidcnam_jasc_281129.jpg
Angioid Streaks - New Extrafoveal Choroidal Neovascular Membrane Right Eye118 views61-year-old woman twelve days ago, saw a spot to the right of her central vision. OD is 20/25, OS is 20/25
Treated with one year of avastin with good result and no vision loss.
00000
(0 votes)
Add to Favorites
angioidcnam_jasc_281229.jpg
Angioid Streaks - New Extrafoveal Choroidal Neovascular Membrane Right Eye117 views61-year-old woman twelve days ago, saw a spot to the right of her central vision. OD is 20/25, OS is 20/25
Treated with one year of avastin with good result and no vision loss.
00000
(0 votes)
Add to Favorites
angioidcnam_jasc_281329.jpg
Angioid Streaks - New Extrafoveal Choroidal Neovascular Membrane Right Eye116 views61-year-old woman twelve days ago, saw a spot to the right of her central vision. OD is 20/25, OS is 20/25

Treated with one year of avastin with good result and no vision loss.
00000
(0 votes)
Add to Favorites
 
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61-year-old woman was seen in the office on 3/24/2009. She noticed March 12th, which is about twelve days ago, a spot to the right of her central vision. She was not doing any lifting or straining at the time and was just sitting and reading a magazine. She has noticed, since it came on, that the vision off to the side might be a little less distorted. In July she did have a clot in her left leg when her leg swelled up and she was put on Coumadin for that. She is now approved to go off Coumadin and go on aspirin, but she has not quite made the transition yet. She was a regular blood donor and donated over five gallons. She is not known to have any blood disorder and she has not been anemic. If anything, her iron levels were a little high for awhile because she was taking oral iron. She has good health otherwise. She also has high blood pressure. VISUAL ACUITY: Vision OD is 20/25, OS is 20/25. IOP: OD 15, OS 12. AMSLER GRID: Right eye paracentral metamorphopsia and the left eye is normal. SLIT LAMP EXAM: Normal with clear lenses in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.0. There is a posterior vitreous separation. There are angioid streaks with most of the streaks going nasally, but there is a streak just going off of the optic nerve at 10:00 o’clock. Adjacent to that is a triangular-shaped subretinal choroidal neovascular membrane with hemorrhage around the edges which stops a disc diameter short of the fovea. OS: Vertical C/D ratio is 0.0. There is a posterior vitreous separation. There are, similarly, angioid streaks around the optic nerve and there is one streak which goes just superior to the fovea. IMPRESSION: 1. IDIOPATHIC ANGIOID STREAKS – BOTH EYES 2. SUBRETINAL CHOROIDAL NEOVASCULAR MEMBRANE – RIGHT EYE 3. AGE-RELATED MACULAR DEGENERATION – RIGHT EYE 4. RETINAL HEMORRHAGE – RIGHT EYE DISCUSSION: I explained to the patient unfortunately there is a blood vessel growth in the right eye which, if left alone, has about an 80% chance of severely impairing her central vision. With intravitreal Avastin, we can reduce the risk of vision loss in that eye and probably even facilitate some vision improvement since the Avastin is excellent at shrinking up the blood vessels and drying up the leakage.