Last additions - Polypoidal Choroidal Vasculopathy - Wet AMD - Disciform Scar 84-year-old woman has polypoidal choroidal vasculopathy in both eyes with macular degeneration. She has macular scars in both eyes and she remains with remarkably good vision in the right eye despite the scarring.
VISUAL ACUITY: OD 20/30, OS 1/200. IOP: OD 13, OS 16. The posterior chamber intraocular lens is in good position in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.2. There is subretinal fibrosis superior, inferior, nasal and temporal to the fovea. The fovea though is relatively spared.
OS: Vertical C/D ratio is 0.2. There is an elevated disciform scar about 8 disc-diameters across, which extends outside the arcades all the way around. Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows irregular hyperfluorescence and staining of subretinal fibrosis, which extends through the fovea. The left eye also has staining subretinal fibrosis. Neither eye has any evidence of any leakage.
IMPRESSION:
1. AGE-RELATED MACULAR DEGENERATION – BOTH EYES
2. MACULAR SCARS – BOTH EYES
3. POLYPOIDAL CHOROIDAL VASCULOPATHY – BOTH EYES
4. REMARKABLY GOOD VISUAL ACUITY – RIGHT EYE
DISCUSSION: I explained to the patient the maculae are both diseased with polypoidal choroidal vasculopathy and macular scarring. The vision in the right eye though remains excellent with treatment. I suggested we continue with therapy. I treated the right eye with intravitreal injection of Avastin (1.25 mg/0.05 ml) without any difficulty today. I asked her to return for a check in six weeks or sooner should she notice a problem and see you back periodically.
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Polypoidal Choroidal Vasculopathy Right Eye - Disciform Scar Left Eye410 views84-year-old woman has polypoidal choroidal vasculopathy in both eyes with macular degeneration. She has macular scars in both eyes and she remains with remarkably good vision in the right eye despite the scarring.
VISUAL ACUITY: OD 20/30, OS 1/200
Avastin Rx ODSep 06, 2011
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Polypoidal Choroidal Vasculopathy Right Eye - Disciform Scar Left Eye296 views84-year-old woman has polypoidal choroidal vasculopathy in both eyes with macular degeneration. She has macular scars in both eyes and she remains with remarkably good vision in the right eye despite the scarring.
VISUAL ACUITY: OD 20/30, OS 1/200
Avastin Rx ODSep 06, 2011
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Polypoidal Choroidal Vasculopathy Right Eye - Disciform Scar Left Eye374 views84-year-old woman has polypoidal choroidal vasculopathy in both eyes with macular degeneration. She has macular scars in both eyes and she remains with remarkably good vision in the right eye despite the scarring.
VISUAL ACUITY: OD 20/30, OS 1/200
Avastin Rx ODSep 06, 2011
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Polypoidal Choroidal Vasculopathy Right Eye - Disciform Scar Left Eye395 views84-year-old woman has polypoidal choroidal vasculopathy in both eyes with macular degeneration. She has macular scars in both eyes and she remains with remarkably good vision in the right eye despite the scarring.
VISUAL ACUITY: OD 20/30, OS 1/200
Avastin Rx ODSep 06, 2011
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Polypoidal Choroidal Vasculopathy Right Eye - Disciform Scar Left Eye370 views84-year-old woman has polypoidal choroidal vasculopathy in both eyes with macular degeneration. She has macular scars in both eyes and she remains with remarkably good vision in the right eye despite the scarring.
VISUAL ACUITY: OD 20/30, OS 1/200
Avastin Rx ODSep 06, 2011
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Polypoidal Choroidal Vasculopathy Right Eye - Disciform Scar Left Eye357 views84-year-old woman has polypoidal choroidal vasculopathy in both eyes with macular degeneration. She has macular scars in both eyes and she remains with remarkably good vision in the right eye despite the scarring.
VISUAL ACUITY: OD 20/30, OS 1/200
Avastin Rx ODSep 06, 2011
|
|
Polypoidal Choroidal Vasculopathy Right Eye - Disciform Scar Left Eye368 views84-year-old woman has polypoidal choroidal vasculopathy in both eyes with macular degeneration. She has macular scars in both eyes and she remains with remarkably good vision in the right eye despite the scarring.
VISUAL ACUITY: OD 20/30, OS 1/200
Avastin Rx ODSep 06, 2011
|
|
Polypoidal Choroidal Vasculopathy Right Eye - Disciform Scar Left Eye423 views84-year-old woman has polypoidal choroidal vasculopathy in both eyes with macular degeneration. She has macular scars in both eyes and she remains with remarkably good vision in the right eye despite the scarring.
VISUAL ACUITY: OD 20/30, OS 1/200
Avastin Rx ODSep 06, 2011
|
|
Polypoidal Choroidal Vasculopathy Right Eye - Disciform Scar Left Eye391 views84-year-old woman has polypoidal choroidal vasculopathy in both eyes with macular degeneration. She has macular scars in both eyes and she remains with remarkably good vision in the right eye despite the scarring.
VISUAL ACUITY: OD 20/30, OS 1/200
Avastin Rx ODSep 06, 2011
|
|
Polypoidal Choroidal Vasculopathy Right Eye - Disciform Scar Left Eye513 views84-year-old woman has polypoidal choroidal vasculopathy in both eyes with macular degeneration. She has macular scars in both eyes and she remains with remarkably good vision in the right eye despite the scarring.
VISUAL ACUITY: OD 20/30, OS 1/200
Avastin Rx ODSep 06, 2011
|
|
Polypoidal Choroidal Vasculopathy Right Eye - Disciform Scar Left Eye384 views84-year-old woman has polypoidal choroidal vasculopathy in both eyes with macular degeneration. She has macular scars in both eyes and she remains with remarkably good vision in the right eye despite the scarring.
VISUAL ACUITY: OD 20/30, OS 1/200
Avastin Rx ODSep 06, 2011
|
|
Polypoidal Choroidal Vasculopathy Right Eye - Disciform Scar Left Eye343 views84-year-old woman has polypoidal choroidal vasculopathy in both eyes with macular degeneration. She has macular scars in both eyes and she remains with remarkably good vision in the right eye despite the scarring.
VISUAL ACUITY: OD 20/30, OS 1/200
Avastin Rx ODSep 06, 2011
|
|
Polypoidal Choroidal Vasculopathy Right Eye - Disciform Scar Left Eye425 views84-year-old woman has polypoidal choroidal vasculopathy in both eyes with macular degeneration. She has macular scars in both eyes and she remains with remarkably good vision in the right eye despite the scarring.
VISUAL ACUITY: OD 20/30, OS 1/200
Avastin Rx ODSep 06, 2011
|
|
Polypoidal Choroidal Vasculopathy Right Eye - Disciform Scar Left Eye467 views84-year-old woman has polypoidal choroidal vasculopathy in both eyes with macular degeneration. She has macular scars in both eyes and she remains with remarkably good vision in the right eye despite the scarring.
VISUAL ACUITY: OD 20/30, OS 1/200
Avastin Rx ODSep 06, 2011
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84-year-old woman has polypoidal choroidal vasculopathy in both eyes with macular degeneration. She has macular scars in both eyes and she remains with remarkably good vision in the right eye despite the scarring.
VISUAL ACUITY: OD 20/30, OS 1/200. IOP: OD 13, OS 16. The posterior chamber intraocular lens is in good position in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.2. There is subretinal fibrosis superior, inferior, nasal and temporal to the fovea. The fovea though is relatively spared.
OS: Vertical C/D ratio is 0.2. There is an elevated disciform scar about 8 disc-diameters across, which extends outside the arcades all the way around. Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows irregular hyperfluorescence and staining of subretinal fibrosis, which extends through the fovea. The left eye also has staining subretinal fibrosis. Neither eye has any evidence of any leakage.
IMPRESSION:
1. AGE-RELATED MACULAR DEGENERATION – BOTH EYES
2. MACULAR SCARS – BOTH EYES
3. POLYPOIDAL CHOROIDAL VASCULOPATHY – BOTH EYES
4. REMARKABLY GOOD VISUAL ACUITY – RIGHT EYE
DISCUSSION: I explained to the patient the maculae are both diseased with polypoidal choroidal vasculopathy and macular scarring. The vision in the right eye though remains excellent with treatment. I suggested we continue with therapy. I treated the right eye with intravitreal injection of Avastin (1.25 mg/0.05 ml) without any difficulty today. I asked her to return for a check in six weeks or sooner should she notice a problem and see you back periodically.
