A 65-year-old man with a history of two sessions of photodynamic therapy with Verteporfin (PDT) and proposed for a third, came for assessment. His current visual acuity is 0.7 in the right eye (OD). This is a single eye as the left eye (OI) is in ptisis bulbi due to a traumatic antecedent that occurred in his childhood. The patient reported no changes since the onset of the condition, nor had he noticed any change in his visual acuity prior to the PDT sessions. Funduscopic imaging revealed a raised vitelliform lesion in the foveal area with hard drusen in the posterior pole. Fluorescein angiography (FFA) shows a progressive and intense ring hyperfluorescence at late times with a hypofluorescent central zone. Indocyanine green angiography (IVGA) shows no alterations of interest. OCT showed the presence of a medium-high reflectivity wedge-shaped structure between the pigmented epithelium and the neurosensory retina with a detachment of the neurosensory retina bordering the lesion. An electrooculogram was performed and the result was within normal limits.
The patient was diagnosed with DFVA and it was decided to carry out regular check-ups. At the 3-, 6- and 12-month check-ups, the test results showed no variation with respect to the first visit and his visual acuity remained stable.
At the 24-month check-up her visual acuity was 0.02. The fundus examination did not show the vitelliform lesion but a rounded orange lesion in the foveal area. In both FFA and AVI there is intense hypofluorescence maintained throughout the angiographic period. OCT shows a normal foveal depression with absence of the mid-reflective mass seen at the first visit and an increase in posterior reflectivity at the level of the pigment-coriocapillary epithelium complex.

