PMC9200588_01
Color fundus photographs of the right (a) and left (b) eyes and the left macula (c). Fundus autofluorescence of the right (d) and left (e) eyes.
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fig1
On fundoscopy, innumerable drusen/pachydrusen were found in the posterior poles of both eyes (Figures 1(a) and 1(b)). Pachydrusen was found in the fovea of the left eye (Figure 1(c)). Fundus autofluorescence imaging using a confocal scanning laser scanning ophthalmoscope (Spectralis HRA, Heidelberg Engineering, Heidelberg, Germany) showed autofluorescence of the drusen on the temporal side of the macula of both eyes (Figures 1(d) and 1(e)).
Horizontal optical coherence tomography (OCT) B-scan of the left eye (a) and OCT angiography of the left eye (b).
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fig2
OCT (Cirrus 5000 Carl Zeiss Meditec, Dublin, CA) showed that the pachydrusen located at the RPE level were subfoveal in the left eye (Figure 2(a)). OCTA identified a blood flow signal in the subfoveal pachydrusen (Figure 2(b)).
Fluorescein angiograms of the early (a) and late (b) phases in the left eye. Indocyanine green angiograms of the early (c) and late (d) phases in the left eye.
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fig3
Fluorescein angiography (Figures 3(a) and 3(b)) and indocyanine green angiography (Figures 3(c) and 3(d)) revealed no hyperfluorescence/leakage, abnormal vasculature, vascular network, or polypoidal/aneurysmal lesions at the macula in the left eye in the early (Figures 3(a) and 3(c)) to late phase images (Figures 3(b) and 3(d)).
Optical coherence tomography angiography at baseline (a), 1 month later (b), and 13 months later (c) in the left eye.
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fig4
One month after presentation, her decimal best-corrected visual acuity was 1.5 in the left eye, and the size of the flow signal remained unchanged (Figures 4(a) and 4(b)). During the 13-month follow-up, the blood flow signal in OCTA did not change in horizontal diameter, and no exudative changes were observed (Figure 4(c)).
Horizontal swept-source optical coherence tomography (SS-OCT) B-scan (a) and horizontal B-scan SS-OCT angiography (b) at 13 months after presentation in the left macula.
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fig5
Topcon, Tokyo, Japan), subfoveal pachydrusen were clearly observed between the RPE and Bruch's membrane (Figure 5(a)), and the blood flow signal was detected within the pachydrusen (Figure 5(b)). The subfoveal choroidal thickness was 274 mum.
Clinical timeline of the female patient. OU: both eyes; FA: fluorescein angiography; ICGA: indocyanine green angiography; OCT: optical coherence tomography; OCTA: OCT angiography; SS-OCT: swept source OCT; VA: corrected visual acuity.
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fig6
Clinical timeline of the patient is described in Figure 6.