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Ophthalmic Images |

Fernlike Maculopathy in a Patient With Central Retinal Vein Occlusion Online Only

Wai Kwan Lily Lai, MBBS, BSc1; Mostafa A. Elgohary, MBChB, MSc, MD, FRCSEd, FRCSI, FRCOphth1
[+] Author Affiliations
1Royal Eye Unit, Kingston Hospital, Kingston Upon Thames, England
JAMA Ophthalmol. 2016;134(6):e156131. doi:10.1001/jamaophthalmol.2015.6131.
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This case report describes a woman in her 60s with fernlike distribution of hypoautofluorescence at the macula.

A woman in her 60s with hypertension presented with acute left patchy scotoma. The right eye was amblyopic due to an old macular scar. Visual acuity was 20/200 OD and 20/40 OS. Left eye examination showed perivenular whitening in the macula, dilated veins in all 4 quadrants, and a few dot hemorrhages (Figure, A). Autofluorescence scan showed fernlike distribution of hypoautofluorescence at the macula (Figure, B). This was diagnosed as central retinal vein occlusion. She subsequently developed additional intraretinal hemorrhages and macular edema, requiring 3 injections of intravitreal aflibercept (EYLEA), 2.0 mg, with visual acuity maintained at 20/40 through 6 months of follow-up.

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Figure.
A, Fundus color photograph showing perivenular retinal whitening (white arrowheads) and a few scattered intraretinal dot hemorrhages (black arrowheads). B, Fundus autofluorescence demonstrating fernlike distribution of hypofluorescence (white arrowheads) corresponding to areas of perivenular retinal whitening.
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