PMC6267888_01
Multimodal imaging of right eye. a Color fundus photography. Normal fundus pigmentation. There is arteriolar tortuosity, opacification (copper or silver wiring) of the arteriolar wall and mild AV nicking consistent with mild hypertensive retinopathy. There are scattered microaneurysms consistent with mild nonproliferative diabetic retinopathy (NPDR). b Green fundus autofluorescence. Normal FAF. c Fluorescein angiography, mid arteriovenous phase. Microaneurysms appear as hyperfluorescent dots. d SD-OCT (horizontal scan). The shallow rudimentary foveal depression, incursion of inner retinal layers, widening of outer nuclear layer (ONL) and lengthening of outer segments are consistent with grade 1 foveal hypoplasia (fovea plana). e En-face OCTA slabs of superficial capillary plexus, deep capillary plexus, outer retina and choriocapillaris (from left to right). The SCP slab shows a very small FAZ area and the presence of macular foveal capillaries crossing the FAZ. The DCP slab shows reduced FAZ area, but wider than SCP FAZ. Outer retina and choriocapillaris slabs are normal and show no neovascularization. f B-scan structural OCT with angiographic overlay shows fovea plana and the presence of flow signals (red) in the foveal region at the levels of both SCP and DCP
40942_2018_147_Fig1_HTML.jpg
PMC6267888_01_40942_2018_147_Fig1_HTML.jpg
Fig1
Multimodal imaging of left eye. a Color fundus photography. Normal fundus pigmentation. There are similar hypertensive and diabetic changes to the right eye. There is a subfoveal disciform scar surrounded by an area of pigmentary disturbance occupying almost the entire macula. b Green fundus autofluorescence. The fovea shows a central zone of decreased FAF surrounded by a ring of increased FAF, which is surrounded by an area of decreased FAF. This triple zone corresponds to the disciform scar and surrounding areas of RPE disturbance and atrophy. The triple zone is surrounded by a larger area of mildly increased FAF occupying almost the entire macula, corresponding to diseased RPE and suggestive of prior presence of subretinal fluid. c Fluorescein angiography, mid arteriovenous phase. Microaneurysms appear as hyperfluorescent dots. There is a hyperfluorescent lesion at the fovea that shows intense staining, but not leakage, consistent with scar tissue. The lesion is surrounded by a hypofluorescent rim due to blockage by pigment, which is surrounded by a large area of mild hyperfluorescence representing a window defect. d SD-OCT (horizontal scan). There is subretinal hyperreflective material, part of which occupies almost the entire thickness of the foveal region. There are tiny cysts present mainly in the inner nuclear layer and 1 cyst in the ganglion cell layer. e En-face OCTA slabs of superficial capillary plexus, deep capillary plexus, outer retina and choriocapillaris (from left to right). There is a large type 2 macular neovascular complex originating deep in the choroid and extending into the innermost retinal layers. The lesion is noted mainly on the outer retina and choriocapillaris slabs, and the top part of the lesion appears as a small neovascular tuft on the SCP and DCP slabs. f B-scan structural OCT with angiographic overlay shows flow signals (red) within the subretinal hyperreflective material consistent with type 2 neovascularization
40942_2018_147_Fig2_HTML.jpg
PMC6267888_01_40942_2018_147_Fig2_HTML.jpg
Fig2