case_images: PMC6380146_01
case_images: Family pedigree of the patient
case_images: OJO-12-37-g001.jpg
case_images: PMC6380146_01_OJO-12-37-g001.jpg
case_images: F1
case_images: His family history was unremarkable [Figure 1].
case_images: Fundus photograph of a yellow lesion in the macula with subretinal hemorrhage (a). A similar but smaller lesion with no hemorrhage was found in the left macula (b). FFA of the right fundus (c) showed a central hyperfluorescent area (leakage) surrounded by well-circumscribed hypofluorescence (blockage), consistent with choroidal neovascularization. FFA of the left fundus was unremarkable (d)
case_images: OJO-12-37-g002.jpg
case_images: PMC6380146_01_OJO-12-37-g002.jpg
case_images: F2
case_images: The right eye lesion was elevated and surrounded by a relatively fresh subretinal hemorrhage and fluid consistent with minimally active CNV [Figure 2a] and relatively flat in the left eye [Figure 2b]. Fluorescein angiography showed a central hyperfluorescent area surrounded by well-circumscribed hypofluorescence caused by the subretinal hemorrhage, which is consistent with minimally active CNV OD [Figure 2c]. Fundus Fluorescein angiography (FFA) of the left eye was essentially normal [Figure 2d].
case_images: Optical coherence tomography of the right macula (a) showing elevated neurosensory retina with an underlying hyper-reflective lesion and sub retinal fluid. A smaller hyper-reflective subfoveal lesion was revealed on left eye optical coherence tomography (b)
case_images: OJO-12-37-g003.jpg
case_images: PMC6380146_01_OJO-12-37-g003.jpg
case_images: F3
case_images: Optical coherence tomography revealed a subretinal, hyperreflective lesion causing elevation of the neurosensory retina in the macular area [Figure 3a]. A small, subretinal, hyperreflective area was seen in the left eye, without retinal elevation [Figure 3b].
case_images: Pattern electroretinogram showing marked reduction in P50 (arrow head) and N95 (arrow) waves amplitude in the right eye and normal waves in the left eye. This indicates a severe macular dysfunction in the right eye
case_images: OJO-12-37-g004.jpg
case_images: PMC6380146_01_OJO-12-37-g004.jpg
case_images: F4
case_images: Moreover, there was a reduction in P50 and N90 amplitude in the right eye PERG [Figure 4].
case_images: Electro-oculogram from both eyes showing normal peak/trough (Arden) ratio in both eyes. Right eye 3.08; Left eye 3.66 (normal >1.8-2)
case_images: OJO-12-37-g005.jpg
case_images: PMC6380146_01_OJO-12-37-g005.jpg
case_images: F5
case_images: The EOG was normal in both eyes with Arden ratio of 3.06 in the right eye and of 3.66 in the left eye (normal Arden ratio: >1.8-2.0) [Figure 5].