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Most viewed - PED - Exudate (fellow eye RPE Hyperplasia)

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)1116 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 20/400
dryamdpighy_esei03~0.jpg
 Hyperpigmentation of Retinal Pigment Epithlium in Dry AMD (hyperplasia)1044 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 20/400
wetamdped_esei03~0.jpg
 Pigment Epithelial Detachment with Subretinal Fluid and Exudate 20/400 Vision759 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 20/400
dryamdpighy_esei02~0.jpg
 Hyperpigmentation of Retinal Pigment Epithlium in Dry AMD (hyperplasia)727 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 20/400
wetamdped_esei01~0.jpg
 Pigment Epithelial Detachment with Subretinal Fluid and Exudate 20/400 Vision688 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 20/400
dryamdpighy_esei05~0.jpg
 Hyperpigmentation of Retinal Pigment Epithlium in Dry AMD (hyperplasia)677 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 20/400
wetamdped_esei06~0.jpg
 Pigment Epithelial Detachment with Subretinal Fluid and Exudate 20/400 Vision637 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 20/400
dryamdpighy_esei04~0.jpg
 Hyperpigmentation of Retinal Pigment Epithlium in Dry AMD (hyperplasia)634 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 20/400
wetamdped_esei02~0.jpg
 Pigment Epithelial Detachment with Subretinal Fluid and Exudate 20/400 Vision630 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 20/400
wetamdped_esei10~0.jpg
 Pigment Epithelial Detachment with Subretinal Fluid and Exudate 20/400 Vision601 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 20/400
wetamdped_esei09~0.jpg
 Pigment Epithelial Detachment with Subretinal Fluid and Exudate 20/400 Vision578 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 20/400
dryamdpighy_esei09~0.jpg
 Hyperpigmentation of Retinal Pigment Epithlium in Dry AMD (hyperplasia)573 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 20/400
wetamdped_esei05~0.jpg
 Pigment Epithelial Detachment with Subretinal Fluid and Exudate 20/400 Vision551 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 20/400
wetamdped_esei08~0.jpg
 Pigment Epithelial Detachment with Subretinal Fluid and Exudate 20/400 Vision548 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 20/400
wetamdped_esei04~0.jpg
 Pigment Epithelial Detachment with Subretinal Fluid and Exudate 20/400 Vision545 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 20/400
dryamdpighy_esei07~0.jpg
 Hyperpigmentation of Retinal Pigment Epithlium in Dry AMD (hyperplasia)543 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 20/400
dryamdpighy_esei08~0.jpg
 Hyperpigmentation of Retinal Pigment Epithlium in Dry AMD (hyperplasia)533 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 20/400
dryamdpighy_esei06~0.jpg
 Hyperpigmentation of Retinal Pigment Epithlium in Dry AMD (hyperplasia)527 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 20/400
wetamdped_esei07~0.jpg
 Pigment Epithelial Detachment with Subretinal Fluid and Exudate 20/400 Vision480 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 20/400
 
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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.