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87-year-old woman has wet age-related macular degeneration in the left eye. She had treatment up north but there has been a gap in therapy and the vision in the left eye is poor. The vision in the right eye remains good. VISUAL ACUITY: Vision OD is 20/25, OS is 20/400. IOP: OU 18. The posterior chamber intraocular lens is in good position in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There are hyperpigmented spots in the macula. There is no intraretinal or subretinal fluid. OS: Vertical C/D ratio is 0.1. There is a pigment epithelial detachment centrally with exudate at the edge as well as subretinal fluid and hemorrhage. Photos confirm clinical findings. FLUORESCEIN ANGIOGRAM: Shows an occult subfoveal choroidal neovascular membrane in the left eye about 4 disc areas in size. The right eye has staining of drusen and hypofluorescence corresponding to the macular pigment. Temporal to the fovea, about 1-disc diameter from the center, there is a disc area of irregular hyperfluorescence. It is associated with a spot of hemorrhage, which may represent an occult asymptomatic extrafoveal choroidal neovascular membrane. IMPRESSION: 1. WET AGE-RELATED MACULAR DEGENERATION – LEFT EYE 2. PIGMENT EPITHELIAL DETACHMENT – LEFT EYE 3. SEROUS MACULAR DETEACHMENT – LEFT EYE 4. MACULAR HEMORRHAGE – LEFT EYE 5. DRY AGE-RELATED MACULAR DEGENERATION WITH HIGH-RISK CHARACTERISTICS 6. POSSIBLE OCCULT EXTRAFOVEAL CHOROIDAL NEOVASCULAR MEMBRANE – RIGHT EYE DISCUSSION: I explained to the patient the macula in the left eye is wet. With intravitreal injections there is an excellent chance of maintaining her vision and possibly improving it. I treated with intravitreal injection of Avastin (1.25 mg/0.05 ml) without any difficulty today.

dryamdpighy_esei01~0.jpg
Hyperpigmentation of Retinal Pigment Epithlium in Dry AMD (hyperplasia)395 views87-year-old woman has wet age-related macular degeneration in the left eye. She had treatment up north but there has been a gap in therapy and the vision in the left eye is poor. Vision OD is 20/25, OS is 20/40000000
(0 votes)
dryamdpighy_esei02~0.jpg
Hyperpigmentation of Retinal Pigment Epithlium in Dry AMD (hyperplasia)283 views87-year-old woman has wet age-related macular degeneration in the left eye. She had treatment up north but there has been a gap in therapy and the vision in the left eye is poor. Vision OD is 20/25, OS is 20/40000000
(0 votes)
dryamdpighy_esei03~0.jpg
Hyperpigmentation of Retinal Pigment Epithlium in Dry AMD (hyperplasia)227 views87-year-old woman has wet age-related macular degeneration in the left eye. She had treatment up north but there has been a gap in therapy and the vision in the left eye is poor. Vision OD is 20/25, OS is 20/40044444
(1 votes)
dryamdpighy_esei04~0.jpg
Hyperpigmentation of Retinal Pigment Epithlium in Dry AMD (hyperplasia)144 views87-year-old woman has wet age-related macular degeneration in the left eye. She had treatment up north but there has been a gap in therapy and the vision in the left eye is poor. Vision OD is 20/25, OS is 20/40000000
(0 votes)
dryamdpighy_esei05~0.jpg
Hyperpigmentation of Retinal Pigment Epithlium in Dry AMD (hyperplasia)197 views87-year-old woman has wet age-related macular degeneration in the left eye. She had treatment up north but there has been a gap in therapy and the vision in the left eye is poor. Vision OD is 20/25, OS is 20/40000000
(0 votes)
dryamdpighy_esei06~0.jpg
Hyperpigmentation of Retinal Pigment Epithlium in Dry AMD (hyperplasia)99 views87-year-old woman has wet age-related macular degeneration in the left eye. She had treatment up north but there has been a gap in therapy and the vision in the left eye is poor. Vision OD is 20/25, OS is 20/40000000
(0 votes)
dryamdpighy_esei07~0.jpg
Hyperpigmentation of Retinal Pigment Epithlium in Dry AMD (hyperplasia)138 views87-year-old woman has wet age-related macular degeneration in the left eye. She had treatment up north but there has been a gap in therapy and the vision in the left eye is poor. Vision OD is 20/25, OS is 20/40000000
(0 votes)
dryamdpighy_esei08~0.jpg
Hyperpigmentation of Retinal Pigment Epithlium in Dry AMD (hyperplasia)132 views87-year-old woman has wet age-related macular degeneration in the left eye. She had treatment up north but there has been a gap in therapy and the vision in the left eye is poor. Vision OD is 20/25, OS is 20/40000000
(0 votes)
dryamdpighy_esei09~0.jpg
Hyperpigmentation of Retinal Pigment Epithlium in Dry AMD (hyperplasia)152 views87-year-old woman has wet age-related macular degeneration in the left eye. She had treatment up north but there has been a gap in therapy and the vision in the left eye is poor. Vision OD is 20/25, OS is 20/40000000
(0 votes)
wetamdped_esei01~0.jpg
Pigment Epithelial Detachment with Subretinal Fluid and Exudate 20/400 Vision217 views87-year-old woman has wet age-related macular degeneration in the left eye. She had treatment up north but there has been a gap in therapy and the vision in the left eye is poor. Vision OD is 20/25, OS is 20/40000000
(0 votes)
wetamdped_esei02~0.jpg
Pigment Epithelial Detachment with Subretinal Fluid and Exudate 20/400 Vision160 views87-year-old woman has wet age-related macular degeneration in the left eye. She had treatment up north but there has been a gap in therapy and the vision in the left eye is poor. Vision OD is 20/25, OS is 20/40000000
(0 votes)
wetamdped_esei03~0.jpg
Pigment Epithelial Detachment with Subretinal Fluid and Exudate 20/400 Vision227 views87-year-old woman has wet age-related macular degeneration in the left eye. She had treatment up north but there has been a gap in therapy and the vision in the left eye is poor. Vision OD is 20/25, OS is 20/40000000
(0 votes)
wetamdped_esei04~0.jpg
Pigment Epithelial Detachment with Subretinal Fluid and Exudate 20/400 Vision141 views87-year-old woman has wet age-related macular degeneration in the left eye. She had treatment up north but there has been a gap in therapy and the vision in the left eye is poor. Vision OD is 20/25, OS is 20/40000000
(0 votes)
wetamdped_esei05~0.jpg
Pigment Epithelial Detachment with Subretinal Fluid and Exudate 20/400 Vision137 views87-year-old woman has wet age-related macular degeneration in the left eye. She had treatment up north but there has been a gap in therapy and the vision in the left eye is poor. Vision OD is 20/25, OS is 20/40000000
(0 votes)
wetamdped_esei06~0.jpg
Pigment Epithelial Detachment with Subretinal Fluid and Exudate 20/400 Vision143 views87-year-old woman has wet age-related macular degeneration in the left eye. She had treatment up north but there has been a gap in therapy and the vision in the left eye is poor. Vision OD is 20/25, OS is 20/40033333
(1 votes)
wetamdped_esei07~0.jpg
Pigment Epithelial Detachment with Subretinal Fluid and Exudate 20/400 Vision75 views87-year-old woman has wet age-related macular degeneration in the left eye. She had treatment up north but there has been a gap in therapy and the vision in the left eye is poor. Vision OD is 20/25, OS is 20/40000000
(0 votes)
wetamdped_esei08~0.jpg
Pigment Epithelial Detachment with Subretinal Fluid and Exudate 20/400 Vision136 views87-year-old woman has wet age-related macular degeneration in the left eye. She had treatment up north but there has been a gap in therapy and the vision in the left eye is poor. Vision OD is 20/25, OS is 20/40000000
(0 votes)
wetamdped_esei09~0.jpg
Pigment Epithelial Detachment with Subretinal Fluid and Exudate 20/400 Vision117 views87-year-old woman has wet age-related macular degeneration in the left eye. She had treatment up north but there has been a gap in therapy and the vision in the left eye is poor. Vision OD is 20/25, OS is 20/40000000
(0 votes)
wetamdped_esei10~0.jpg
Pigment Epithelial Detachment with Subretinal Fluid and Exudate 20/400 Vision151 views87-year-old woman has wet age-related macular degeneration in the left eye. She had treatment up north but there has been a gap in therapy and the vision in the left eye is poor. Vision OD is 20/25, OS is 20/40000000
(0 votes)
 
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87-year-old woman has wet age-related macular degeneration in the left eye. She had treatment up north but there has been a gap in therapy and the vision in the left eye is poor. The vision in the right eye remains good. VISUAL ACUITY: Vision OD is 20/25, OS is 20/400. IOP: OU 18. The posterior chamber intraocular lens is in good position in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There are hyperpigmented spots in the macula. There is no intraretinal or subretinal fluid. OS: Vertical C/D ratio is 0.1. There is a pigment epithelial detachment centrally with exudate at the edge as well as subretinal fluid and hemorrhage. Photos confirm clinical findings. FLUORESCEIN ANGIOGRAM: Shows an occult subfoveal choroidal neovascular membrane in the left eye about 4 disc areas in size. The right eye has staining of drusen and hypofluorescence corresponding to the macular pigment. Temporal to the fovea, about 1-disc diameter from the center, there is a disc area of irregular hyperfluorescence. It is associated with a spot of hemorrhage, which may represent an occult asymptomatic extrafoveal choroidal neovascular membrane. IMPRESSION: 1. WET AGE-RELATED MACULAR DEGENERATION – LEFT EYE 2. PIGMENT EPITHELIAL DETACHMENT – LEFT EYE 3. SEROUS MACULAR DETEACHMENT – LEFT EYE 4. MACULAR HEMORRHAGE – LEFT EYE 5. DRY AGE-RELATED MACULAR DEGENERATION WITH HIGH-RISK CHARACTERISTICS 6. POSSIBLE OCCULT EXTRAFOVEAL CHOROIDAL NEOVASCULAR MEMBRANE – RIGHT EYE DISCUSSION: I explained to the patient the macula in the left eye is wet. With intravitreal injections there is an excellent chance of maintaining her vision and possibly improving it. I treated with intravitreal injection of Avastin (1.25 mg/0.05 ml) without any difficulty today.