PMC7085837_01
On the first day. (a and d) Fundus image of the right and left eyes; elevated optic disc with blurred margin and slightly elevated yellow lesion extending from optic nerve head to the macula. (b and e) FAF image of the right and left eyes; hyperautofluorescence bodies on the surface of the optic nerve linked with the drusen and hyperautofluorescent lesion in the papillomacular region. (c and f) FFA image of the right and left eyes; hyperfluorescence and intense leakage that might be associated with CNV. (g) Orbital CT image of the right and left eyes; bright spot on papilla associated with optic disc drusen. (h) SD-OCT image of the right eye; retinal thickening, subretinal hyperreflectivity, and subfoveal fluid in the papillomacular region. (i) SD-OCT image of the left eye; retinal thickening and subretinal hyperreflectivity in the papillomacular region.
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In addition, slightly elevated yellow lesion extending from optic nerve head to the macula was observed bilaterally (Figures 1(a) and 1(d)). FFA, spectral-domain optic coherence tomography (SD-OCT, Cirrus HD OCT 5000, Carl Zeiss Meditec Inc., Dublin, CA, USA), OCTA, orbital USG, and computed tomography (CT). FAF showed bilateral aspect of white refractile and hyperautofluorescence bodies on the surface of the optic nerve linked with the drusen and a hypoautofluorescent and hyperautofluorescent lesion in the papillomacular region (Figures 1(b) and 1(e)). FFA showed no hyperfluorescence or leakage with blurred borders of the optic disc, and early hyperfluorescence and intense leakage that might be associated with CNV were observed in both eyes with the right eye predominance (Figures 1(c) and 1(f)). B-mode USG showed hyperechogenic appearance, and orbital CT revealed papilla as bright spots which might be associated with optic disc drusen (Figure 1(g)). SD-OCT showed retinal thickening, subretinal hyperreflectivity in the papillomacular region bilaterally, and subfoveal fluid in the right eye (Figures 1(h) and 1(i)).
On the first day. (a) Unified and coloured OCTA image of the right eye; circular CNV complex with main trunk, multiple dense thin capillaries branching from the main trunk and frequent anastomoses (yellow). (b) Outer retina cross-section and en face OCTA image of the right eye. (c) Unified and coloured OCTA image of the left eye; CNV with main trunk, minimal vessel loops, and capillaries (yellow). (d) Outer retina cross-section and en face OCTA image of the left eye.
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A large circular CNV complex with main trunk, multiple dense thin capillaries branching from the main trunk in a tree-like manner, and frequent anastomoses was observed in the papillomacular region of the right eye in the outer retina and choriocapillaris cross-sections (Figures 2(a) and 2(b)). In the left eye, CNV with main trunk, minimal vessel loops, and capillaries was observed, which was considered as slightly activated (Figures 2(c) and 2(d)).
At 3 months. (a and b) Outer retina, choriocapillaris cross-sections, and en face OCTA image of the right eye; CNV complex including the main trunk disappearance. (c and d) Outer retina, choriocapillaris cross-sections, and en face OCTA image of the left eye; entire CNV compete of including the main trunk disappearance.
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CNV compete including the main trunk disappeared (Figures 3(a)to 3(d)). CNV complex was not observed with OCTA, and no significant change was observed in the peripapillary and macular vascular density measurements, and findings which might be correlated with RNFL measurements were not detected in 1-year follow-up.