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77-year-old woman was seen in the office on August 8, 2011. She has had poor vision in the right eye since birth. She had congenital toxoplasmosis of her macula in the right eye. She did notice a change in it at some point, probably about fifteen or twenty years ago. She saw a retinal specialist who suggested treatment at the time would be helpful. Her left eye has been good. She was reading, doing everything fine, seeing faces and not having trouble until about two to three weeks ago when she noticed vision loss in the left eye. It has been stable for the last week. She does take a regular aspirin. VISUAL ACUITY: OD 2/200, OS 20/200. IOP: OD 17, OS 15. SLIT EXAMINATION: There is 3+ nuclear sclerosis in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.3. There is no posterior vitreous separation. There is a large macular scar with exudate at the edges. It is centered superotemporal to the macula, but it involves the center of the fovea. OS: Vertical C/D ratio is 0.3. There is no posterior vitreous separation. There is a well circumscribed 2 disc-diameter pigment epithelial detachment centrally. OCT SCAN: The OCT scan shows subretinal fluid in the left eye. Photos confirm clinical findings. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography of the left eye shows a classic subfoveal choroidal neovascular membrane 2 disc areas in size. The right eye shows a large hyperfluorescence macular scar with leakage at the edge. IMPRESSION: 1. WET AGE-RELATED MACULAR DEGENERATION – BOTH EYES 2. MACULAR TOXOPLASMOSIS CURRENT IN RIGHT EYE 3. CLASSIC SUBFOVEAL CHOROIDAL NEOVASCULAR MEMBRANE - LEFT EYE 4. PIGMENT EPITHELIAL DETACHMENT – RIGHT EYE 5. CATARACTS – BOTH EYES DISCUSSION: I explained to the patient the left eye unfortunately does have wet age-related macular degeneration. With injections there is a 90 percent chance of improving the vision some and a 50 percent chance of improving the vision a lot. I warned her that although the treatments are safe and effective, they do need to be repeated monthly, especially in one eye patients. I treated the left eye with intravitreal injection of Lucentis (0.5 mg/0.05 ml) without any difficulty today.

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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 396 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 183 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 325 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 179 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 314 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 152 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 183 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 144 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 113 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 99 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 109 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 79 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 125 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 118 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 81 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 89 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 125 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 114 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 122 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 109 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 174 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 208 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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New Subfoveal Classic CNVM OS - Wet AMD - Macular Scar Congenital Toxoplasmosis Right Eye 196 views77-year-old woman as had poor vision in the right eye since birth from congenital toxoplasmosis of her macula in the right eye. Two to three weeks ago when she noticed vision loss in the left eye. VISUAL ACUITY: OD 2/200, OS 20/200.00000
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77-year-old woman was seen in the office on August 8, 2011. She has had poor vision in the right eye since birth. She had congenital toxoplasmosis of her macula in the right eye. She did notice a change in it at some point, probably about fifteen or twenty years ago. She saw a retinal specialist who suggested treatment at the time would be helpful. Her left eye has been good. She was reading, doing everything fine, seeing faces and not having trouble until about two to three weeks ago when she noticed vision loss in the left eye. It has been stable for the last week. She does take a regular aspirin. VISUAL ACUITY: OD 2/200, OS 20/200. IOP: OD 17, OS 15. SLIT EXAMINATION: There is 3+ nuclear sclerosis in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.3. There is no posterior vitreous separation. There is a large macular scar with exudate at the edges. It is centered superotemporal to the macula, but it involves the center of the fovea. OS: Vertical C/D ratio is 0.3. There is no posterior vitreous separation. There is a well circumscribed 2 disc-diameter pigment epithelial detachment centrally. OCT SCAN: The OCT scan shows subretinal fluid in the left eye. Photos confirm clinical findings. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography of the left eye shows a classic subfoveal choroidal neovascular membrane 2 disc areas in size. The right eye shows a large hyperfluorescence macular scar with leakage at the edge. IMPRESSION: 1. WET AGE-RELATED MACULAR DEGENERATION – BOTH EYES 2. MACULAR TOXOPLASMOSIS CURRENT IN RIGHT EYE 3. CLASSIC SUBFOVEAL CHOROIDAL NEOVASCULAR MEMBRANE - LEFT EYE 4. PIGMENT EPITHELIAL DETACHMENT – RIGHT EYE 5. CATARACTS – BOTH EYES DISCUSSION: I explained to the patient the left eye unfortunately does have wet age-related macular degeneration. With injections there is a 90 percent chance of improving the vision some and a 50 percent chance of improving the vision a lot. I warned her that although the treatments are safe and effective, they do need to be repeated monthly, especially in one eye patients. I treated the left eye with intravitreal injection of Lucentis (0.5 mg/0.05 ml) without any difficulty today.