This is a 55-year-old male patient with a history of hypertension and acute myocardial infarction treated with Clopidogrel (Iscover®), who came to the emergency department for central scotoma and left eye metamorphopsias.
Visual acuity (VA) with correction was 0.9 right eye (OD) and 0.6 left eye.
Eye fundus examination was normal in the right eye and in the left eye there was a vesicular lesion surrounded by hard exudate, deep intraretinal hemorrhage and subretinal retinal detachment 2sensory detachment.
The initial diagnosis was idiopathic neovascular membrane, indicating the realization of fluorescein (AGF) and indocyanine green (AVI) with laserstock, colonography with Rodendo (SLO 101).
FGA showed hyperfluoric extrafoveal neovascular lesion from an early stage with late visualisation of arterioles, afferent vasculature as well as allowing differential phases of drainage.
The LVA clearly showed the small neovascular lesion surrounded by a hypofluorescent halo in the blood.
With the patient commented on the possibility of laser treatment or photodynamic therapy, it was decided to perform the latter to avoid as much as possible the scotoma.
Three months later the VA was 0.7, the metamorphopsias had decreased and the hemorrhage had reabsorbed, but the neurosensory detachment (SND) and hard exudation persisted.
FFA showed hyperfluorescence without diffusion so it was not portrayed.
Six months later the VA was 0.8, the patient was asymptomatic and at the bottom of the eye a juxtamacular scar with discrete alteration of pigment epithelium and without SND was observed.
Three and a half years later the patient remains asymptomatic without changes in the eye fundus.
