case_images: PMC9149341_01
case_images: a, b Fundus color photo which shows the neovascularization lesions (yellow arrow) with a polyp and significant macular exudation of the left eye. c, d Fundus color photo, 2 months follow-up which shows significant improvement and regression of the lesions.
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case_images: PMC9149341_01_cop-0013-0270-g01.jpg
case_images: F1
case_images: However, new grayish peripapillary lesions were noted bilaterally (Fig. 1).
case_images: SD-OCT cuts over the lesions (dash blue line marked in Fig. 1) at presentation of the (a, b) and 4 months follow-up after initiation of systemic treatment (c, d). SD-OCT, spectral domain OCT.
case_images: cop-0013-0270-g02.jpg
case_images: PMC9149341_01_cop-0013-0270-g02.jpg
case_images: F2
case_images: OCT imaging of the lesion in the right eye (Fig. 2a) showed an elevated lesion associated with subretinal hyper-reflective material and retinal thickening (Fig. 2a). OCT imaging of the left eye (Fig. 2b) showed a polypoidal-like lesion with intraretinal fluid. OCT angiography (OCTA) imaging (PLEX Elite 9000; Carl Zeiss Meditec, Dublin, CA, USA) using a segmentation slab between the retinal pigment epithelium and Bruch's membrane confirmed the presence of bilateral peripapillary CNV as shown by the structural images (Fig. 3c, h) and the flow images (Fig. 3d, e, i, j). On follow-up, spectral domain OCT imaging showed apparent improvement of the polypoidal-like projections and resolution of the subretinal fluid and hyper-reflective material (Fig. 2c, d, 4).
case_images: Multimodal imaging demonstrating the CNV of the right and left eyes. a, f Late stage FA leakage. b, g Late stage ICG which shows a polyp-like configuration. c, h En face SS-OCT structural image (c, h) and flow images (d, i, e, j) applied to the slab segmented to visualize detectable flow residing between the RPE and Bruch's membrane. FA, fluorescein angiography.
case_images: cop-0013-0270-g03.jpg
case_images: PMC9149341_01_cop-0013-0270-g03.jpg
case_images: F3
case_images: On imaging, fluorescein angiography demonstrated late leakage of the peripapillary lesions bilaterally (Fig. 3a, f). Indocyanine green angiography showed bilateral peripapillary polypoidal-like neovascular lesions (Fig. 3b, g). OCT angiography (OCTA) imaging (PLEX Elite 9000; Carl Zeiss Meditec, Dublin, CA, USA) using a segmentation slab between the retinal pigment epithelium and Bruch's membrane confirmed the presence of bilateral peripapillary CNV as shown by the structural images (Fig. 3c, h) and the flow images (Fig. 3d, e, i, j). On follow-up, spectral domain OCT imaging showed apparent improvement of the polypoidal-like projections and resolution of the subretinal fluid and hyper-reflective material (Fig. 2c, d, 4).
case_images: Foveal SD-OCT cut of the left eye shows improvement of foveal intra- and subretinal fluid at presentation (a) and 4 months follow-up (b). SD-OCT, spectral domain OCT.
case_images: cop-0013-0270-g04.jpg
case_images: PMC9149341_01_cop-0013-0270-g04.jpg
case_images: F4
case_images: OCT angiography (OCTA) imaging (PLEX Elite 9000; Carl Zeiss Meditec, Dublin, CA, USA) using a segmentation slab between the retinal pigment epithelium and Bruch's membrane confirmed the presence of bilateral peripapillary CNV as shown by the structural images (Fig. 3c, h) and the flow images (Fig. 3d, e, i, j). On follow-up, spectral domain OCT imaging showed apparent improvement of the polypoidal-like projections and resolution of the subretinal fluid and hyper-reflective material (Fig. 2c, d, 4).