A 76-year-old woman experienced sudden painless visual loss in her left eye. Visual acuity was 20/40 OD and 20/30 OS. On fundus examination, the right eye had occult neovascularization and the left eye showed a small epipapillary hemorrhage. No retinal inflammatory infiltrates were identified. Fluorescein angiography of the left eye demonstrated an extrafoveolar neovascular membrane and a large peripapillary and macular hypofluorescence without late staining (Figure, A). Thermal laser photocoagulation was performed in the left eye. The patient had an atrial fibrillation already documented, the hemostasis parameters were under control with coumarin derivatives, and the patient did not have giant cell arteritis. The patient developed successive recurrent large neovascular membranes that correlated nicely with the initial areas of choroidal hypofluorescence (Figure, B-D).
Fluorescein angiography of a 76-year-old woman who experienced sudden painless visual loss in her left eye. A, Acute peripapillary and central hypofluorescence (arrowheads) and first choroidal neovascularization (arrow) in the left eye. At 1 month (B), 3 months (C), and 6 months (D), laser scar (arrowheads) was visible, and extension of the choroidal neovascular front (arrows) eventually correlated with the overall initial area of presumed choroidal hypoperfusion.
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