PMC3884193_01
Fundus photographs, OCT images, and fluorescein and indocyanine green angiograms in a patient with RAP and an RPE detachment. a An RPE detachment, including the fovea, can be seen with multiple drusen. A small intraretinal hemorrhage can be seen (arrow). The patient's visual acuity was 0.15. b OCT image shows a hyperreflective mass above the RPE (arrow) and intra- and subretinal fluid. The location of the scan is shown by a white line in a. c OCT image through the fovea showing the RPE detachment and vitreomacular adhesion. d Late-phase fluorescein angiogram shows a pooling of dye at the site of the RPE detachment. e Indocyanine green angiogram shows a hyperfluorescent spot temporal to the fovea (arrow).
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F1
Ophthalmoscopy showed a shallow RPE detachment and macular edema accompanied by multiple drusen in his right eye (fig. 1a). Optical coherence tomography (OCT) showed an RPE detachment, intraretinal hyperreflectivity and edema (fig. 1b). Vitreoretinal traction was also evident (fig. 1c). Fluorescein angiography showed a pooling of dye corresponding to the RPE detachment (fig. 1d). A hyperfluorescent spot suggesting a retinal choroidal anastomosis was observed by indocyanine green angiography (fig. 1e).
Fundus photographs, OCT image, and fluorescein and indocyanine green angiograms in a patient with RAP and an RPE detachment after 3 monthly injections of ranibizumab. a Fundus image after 3 monthly intravitreal injections of ranibizumab. The RPE detachment is reduced, and the patient's visual acuity improved slightly to 0.2. b OCT image shows a resolution of the RPE detachment. However, the vitreous adhesion to the macula is still present, causing an abnormal shape of the fovea. c Late-phase fluorescein angiogram shows a decrease in the pooling of the dye. d Indocyanine green angiogram shows a small hyperfluorescent spot (arrow). The leakage from a retinal choroidal anastomosis is weaker.
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F2
After 3 monthly injections of intravitreal ranibizumab, the RPE detachment was resolved (fig. 2), and his visual acuity slightly improved to 0.2.
Fundus photographs, OCT image, and fluorescein and indocyanine green angiograms in a patient with RAP and an RPE tear that developed 2 months after vitrectomy for vitreomacular traction. a Fundus photograph 2 months after the vitrectomy. Note the large defect of the RPE (arrowheads) and the rolled epithelium (arrow) temporal to the fovea. b OCT image shows an accumulation of intra- and subretinal fluid. The RPE is rolled (arrow), and the area not covered by the RPE can be seen (arrowheads). c Fluorescein angiogram shows an area of hyperfluorescence corresponding to the RPE tear (arrowheads). d Indocyanine angiography shows the neovascular lesion covered by the contracted RPE (arrow).
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F3
Two months after the surgery, a large tear of the RPE was found over the entire macula (fig. 3).