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69-year-old woman has age-related macular degeneration in the left eye. She had treatment for that starting in 2003 and despite intravitreal Kenalog and photodynamic laser following choroidal laser, her central vision in that eye is poor. The right eye is doing fine as far as she knows, although she was recently having some difficulty with her reading. VISUAL ACUITY: OD 20/40, OS 20/200. IOP: OD 16, OSO 13. The posterior chamber intraocular lens is in good position in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.3. There is a low-lying subfoveal pigment epithelial detachment centered inferior to the fovea. OS: Vertical C/D ratio is 0.3. There is a macular scar. OCT SCAN: The OCT scan of the right eye shows the operculated macular hole, which was there previously but now there is definitely pigment epithelial detachment, predominately inferonasal to the fovea with underlying subretinal fluid. The left eye has retinal atrophy corresponding to the macular scar. Photos confirm clinical findings. FLUORESCEIN ANGIOGRAM: FA shows a small classic subfoveal choroidal neovascular membrane in the right eye. The left eye has a staining macular scar. IMPRESSION: 1. AGE-RELATED MACULAR DEGENERATION – BOTH EYES 2. NEW ONSET SUBFOVEAL CHOROIDAL NEOVASCULAR MEMBRANE – RIGHT AND BETTER EYE 3. MACULAR EDEMA – RIGHT EYE 4. PIGMENT EPITHELIAL DETACHMENT – RIGHT EYE DISCUSSION: I explained to the patient that the macula in the right eye now unfortunately does have a wet subfoveal choroidal neovascular membrane. I suggested we institute treatment with Avastin. I injected her eye today. She will return for a check in one month for re-evaluation and treatment with either Avastin or Lucentis

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Macular Degeneration - Choroidal Laser Left eye - New Subfoveal CNVM left eye - Did well with Avastin161 views69-year-old woman new vision loss right eye and old macular scar left eye. OD 20/40, OS 20/20000000
(0 votes)
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Macular Degeneration - Choroidal Laser Left eye - New Subfoveal CNVM left eye - Did well with Avastin186 views69-year-old woman new vision loss right eye and old macular scar left eye. OD 20/40, OS 20/20000000
(0 votes)
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Macular Degeneration - Choroidal Laser Left eye - New Subfoveal CNVM left eye - Did well with Avastin112 views69-year-old woman new vision loss right eye and old macular scar left eye. OD 20/40, OS 20/20000000
(0 votes)
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Macular Degeneration - Choroidal Laser Left eye - New Subfoveal CNVM left eye - Did well with Avastin107 views69-year-old woman new vision loss right eye and old macular scar left eye. OD 20/40, OS 20/20000000
(0 votes)
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Macular Degeneration - Choroidal Laser Left eye - New Subfoveal CNVM left eye - Did well with Avastin118 views69-year-old woman new vision loss right eye and old macular scar left eye. OD 20/40, OS 20/20000000
(0 votes)
cnvmod_casm_28529.png
Macular Degeneration - Choroidal Laser Left eye - New Subfoveal CNVM left eye - Did well with Avastin108 views69-year-old woman new vision loss right eye and old macular scar left eye. OD 20/40, OS 20/20000000
(0 votes)
cnvmod_casm_28629.png
Macular Degeneration - Choroidal Laser Left eye - New Subfoveal CNVM left eye - Did well with Avastin100 views69-year-old woman new vision loss right eye and old macular scar left eye. OD 20/40, OS 20/20000000
(0 votes)
cnvmod_casm_28729.png
Macular Degeneration - Choroidal Laser Left eye - New Subfoveal CNVM left eye - Did well with Avastin151 views69-year-old woman new vision loss right eye and old macular scar left eye. OD 20/40, OS 20/20000000
(0 votes)
cnvmod_casm.png
Macular Degeneration - Choroidal Laser Left eye - New Subfoveal CNVM left eye - Did well with Avastin179 views69-year-old woman new vision loss right eye and old macular scar left eye. OD 20/40, OS 20/20000000
(0 votes)
     
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69-year-old woman has age-related macular degeneration in the left eye. She had treatment for that starting in 2003 and despite intravitreal Kenalog and photodynamic laser following choroidal laser, her central vision in that eye is poor. The right eye is doing fine as far as she knows, although she was recently having some difficulty with her reading. VISUAL ACUITY: OD 20/40, OS 20/200. IOP: OD 16, OSO 13. The posterior chamber intraocular lens is in good position in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.3. There is a low-lying subfoveal pigment epithelial detachment centered inferior to the fovea. OS: Vertical C/D ratio is 0.3. There is a macular scar. OCT SCAN: The OCT scan of the right eye shows the operculated macular hole, which was there previously but now there is definitely pigment epithelial detachment, predominately inferonasal to the fovea with underlying subretinal fluid. The left eye has retinal atrophy corresponding to the macular scar. Photos confirm clinical findings. FLUORESCEIN ANGIOGRAM: FA shows a small classic subfoveal choroidal neovascular membrane in the right eye. The left eye has a staining macular scar. IMPRESSION: 1. AGE-RELATED MACULAR DEGENERATION – BOTH EYES 2. NEW ONSET SUBFOVEAL CHOROIDAL NEOVASCULAR MEMBRANE – RIGHT AND BETTER EYE 3. MACULAR EDEMA – RIGHT EYE 4. PIGMENT EPITHELIAL DETACHMENT – RIGHT EYE DISCUSSION: I explained to the patient that the macula in the right eye now unfortunately does have a wet subfoveal choroidal neovascular membrane. I suggested we institute treatment with Avastin. I injected her eye today. She will return for a check in one month for re-evaluation and treatment with either Avastin or Lucentis