Vitreous & Retina

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Macular Diseases
AMD demonstrating pigment epithelial detachment associated with soft drusen. Note also some hard drusen and areas of pigment clumping.

  • Not an uncommon finding in AMD
  • Drusenoid PED may be formed by coalesced multiple large, soft drusen.
  • Clinical features:
    • Symptoms: reduced vision and metamorphopsia
    • Signs:
      • Typically appears as dome-shaped, round or oval elevation of the RPE and its underlying basement membrane
      • A detachment of the overlying neurosensory retina may be an evidence of subretinal neovascularization
      • Smooth or homogenous RPE overlying the PED
      • May be associated with overlying pigment clumping or atrophy
      • May remain stable for several years, but eventually flatten and lead to geographic atrophy of the RPE
  • Fluorescein angiogram:
    • Gradual and uniform staining of the sub-RPE material
    • Multiple areas of intense, late hyperfluorescence and "notching" of the uniform hyperfluorescent pooling defect are signs of underlying occult subretinal neovascularization

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