PMC3437952_01
(A and B) show color fundus photographs of the right and left eyes, respectively. The left eye shows serous retinal detachment and exudates. (C and D) show the results of FA (early and late phase, respectively) and show hyperfluorescence (window defect) at the lesion of the PED. (E and F) show the results of IA (early and late phase, respectively) and show polypoidal fluorescence at the yellowish protruding lesion. SD-OCT demonstrates the separation of the retina between the inner segment and the outer segment junctions of the photoreceptor (IS/OS) line and the RPE with choroidal excavation (G).. Note: A protruding lesion was observed in the upper macular area, and PED ran along the upper part.. Abbreviations: FA, fluorescein angiography; PED, pigment epithelium detachment; SD-OCT, spectral-domain optical coherence tomography; IS/OS, inner segment/outer segment; IA, indocyanine green augiography; RPE, retinal pigment epithelium.
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The left fundus showed a small reddish-orange elevated lesion, drusen, exudates, and serous macular detachment in the macular area (Figure 1A). The right fundus showed nothing abnormal (Figure 1B). SD-OCT further revealed separation between the neural retina, the RPE, and the underlying layers (Figure 1C). Fluorescein angiography (FA) (Figure 1D and E) revealed a window defect in the area of the PED, and indocyanine green angiography (IA) showed polypoidal hyperfluorescence in the early (Figure 1F) and late phases (Figure 1G).
(A-C) are fundus photographs and OCT images before anti-VEGF treatment. (D-F) are fundus photographs and OCT images after initial anti-VEGF treatment. (G-I) are fundus photographs and OCT images after three rounds of anti-VEGF treatment. (B, E and H) are vertical OCT images and (C, F and I) are horizontal OCT images. The left eye shows serous retinal detachment and exudates (A). A choroidal excavation is located just inside the macular area. As described in Figure 1, the OCT images show the separation of the retina between the IS/OS line and the RPE (B). The horizontal image shows choroidal excavation more clearly than the vertical image (C). The left eye shows more exudates than that of her initial visit to us (A) (D) and an increase in serous retinal detachment (E and F). The retinal exudates increased after the 3 injections (G), but serous retinal detachment decreased (H and I).. Note: The extent of PED may have increased.. Abbreviations: OCT, optical coherence tomography; VEGF, vascular endothelial growth factor; IS/OS, inner segment/outer segment; RPE, retinal pigment epithelium; PED, pigment epithelium detachment.
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Specifically, the serous retinal detachment and exudates increased (Figure 2D-F). However, improvement of the serous retinal detachment was observed after the third injection (Figure 2H and I), and her visual acuity remained at (0.8) at a follow-up visit 6 months later.