Most viewed - Hyperpigmentation of Retinal Pigment Epithelium with Wet Fellow Eye 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.
|

Hyperpigmentation of the Retinal Pigment Epithelium in Dry AMD1326 views87-year-old woman has wet age-related macular degeneration in the left eye. Vision OD is 20/25, OS is 20/400
|
|

Hyperpigmentation of the Retinal Pigment Epithelium in Dry AMD997 views87-year-old woman has wet age-related macular degeneration in the left eye. Vision OD is 20/25, OS is 20/400
|
|

Hyperpigmentation of the Retinal Pigment Epithelium in Dry AMD974 views87-year-old woman has wet age-related macular degeneration in the left eye. Vision OD is 20/25, OS is 20/400
|
|

Hyperpigmentation of the Retinal Pigment Epithelium in Dry AMD956 views87-year-old woman has wet age-related macular degeneration in the left eye. Vision OD is 20/25, OS is 20/400
|
|

Wet AMD - PED with exudate 20/400 87 Year old740 views87-year-old woman has wet age-related macular degeneration in the left eye. Vision OD is 20/25, OS is 20/400
|
|

Wet AMD - PED with exudate 20/400 87 Year old714 views87-year-old woman has wet age-related macular degeneration in the left eye. Vision OD is 20/25, OS is 20/400
|
|

Hyperpigmentation of the Retinal Pigment Epithelium in Dry AMD700 views87-year-old woman has wet age-related macular degeneration in the left eye. Vision OD is 20/25, OS is 20/400
|
|

Hyperpigmentation of the Retinal Pigment Epithelium in Dry AMD676 views87-year-old woman has wet age-related macular degeneration in the left eye. Vision OD is 20/25, OS is 20/400
|
|

Wet AMD - PED with exudate 20/400 87 Year old673 views87-year-old woman has wet age-related macular degeneration in the left eye. Vision OD is 20/25, OS is 20/400
|
|

Wet AMD - PED with exudate 20/400 87 Year old666 views87-year-old woman has wet age-related macular degeneration in the left eye. Vision OD is 20/25, OS is 20/400
|
|

Wet AMD - PED with exudate 20/400 87 Year old661 views87-year-old woman has wet age-related macular degeneration in the left eye. Vision OD is 20/25, OS is 20/400
|
|

Hyperpigmentation of the Retinal Pigment Epithelium in Dry AMD622 views87-year-old woman has wet age-related macular degeneration in the left eye. Vision OD is 20/25, OS is 20/400
|
|

Wet AMD - PED with exudate 20/400 87 Year old621 views87-year-old woman has wet age-related macular degeneration in the left eye. Vision OD is 20/25, OS is 20/400
|
|

Wet AMD - PED with exudate 20/400 87 Year old618 views87-year-old woman has wet age-related macular degeneration in the left eye. Vision OD is 20/25, OS is 20/400
|
|

Wet AMD - PED with exudate 20/400 87 Year old608 views87-year-old woman has wet age-related macular degeneration in the left eye. Vision OD is 20/25, OS is 20/400
|
|

Wet AMD - PED with exudate 20/400 87 Year old606 views87-year-old woman has wet age-related macular degeneration in the left eye. Vision OD is 20/25, OS is 20/400
|
|

Hyperpigmentation of the Retinal Pigment Epithelium in Dry AMD603 views87-year-old woman has wet age-related macular degeneration in the left eye. Vision OD is 20/25, OS is 20/400
|
|

Wet AMD - PED with exudate 20/400 87 Year old595 views87-year-old woman has wet age-related macular degeneration in the left eye. Vision OD is 20/25, OS is 20/400
|
|

Hyperpigmentation of the Retinal Pigment Epithelium in Dry AMD581 views87-year-old woman has wet age-related macular degeneration in the left eye. Vision OD is 20/25, OS is 20/400
|
|
|
|
|
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.