case_images: PMC7452954_01
case_images: Color fundus photograph (CFP) showed angioid streaks (AS) in the right eye (a) and the left eye (b) (black arrows), and choroidal neovascular membrane (CNV) (white arrow) in the left eye (b). Spectral domain optical coherence tomography SD-OCT (c) showed CNV (black arrow) with subretinal fluid (red star).
case_images: OC-10-38-g-001.jpg
case_images: PMC7452954_01_OC-10-38-g-001.jpg
case_images: F1
case_images: CFP showed bilateral AS (Figure 1a, b (Fig. 1)) and choroidal neovascular membrane (CNV) in the left eye (Figure 1b (Fig. 1)). Spectral domain optical coherence tomography (SD-OCT) showed CNV with subretinal fluid in the left eye (Figure 1c (Fig. 1)).
case_images: Multicolor imaging (MC) of both eyes highlighted AS in dark orange color (a, c) (black arrows). AS were better visualized in infrared reflectance (IR) (b, d) (black arrows) as compared to green reflectance (GR) (e, g) and blue reflectance (BR) (f, h). MC of the left eye showed CNV in greenish color (c) (white arrow) with corresponding IR (d), GR (g) and BR (h) images.
case_images: OC-10-38-g-002.jpg
case_images: PMC7452954_01_OC-10-38-g-002.jpg
case_images: F2
case_images: MC of both eyes (Figure 2a, c (Fig. 2)) highlighted AS in dark orange color. AS were better visualized in infrared reflectance (IR) (Figure 2b, d (Fig. 2)) as compared to green reflectance (GR) (Figure 2e, g (Fig. 2)) and blue reflectance (BR) (Figure 2f, h (Fig. 2)). MC of the left eye also showed CNV in greenish color (Figure 2c (Fig. 2)).
case_images: PMC7452954_02
case_images: CFP (a, b) showed bilateral AS (black arrows) with peau d'orange as alternating dark and bright patches (arrow heads). Subretinal crystalline bodies and round white lesions without tails were seen surrounding the optic disc, suggestive of atypical drusen (white arrows). Spots of chorioretinal atrophy with variable size and "punched-out" appearance were seen in mid-periphery, suggestive of comet lesions. Comet lesions of both eyes showed a focal increased fundus autofluorescence (c, d) (red arrows) and a hyperfluorescence on late phase fundus fluorescein angiography (e and f) (red arrows). The associated comet tail that usually leaves the focal atrophy toward the posterior pole could be seen as hyperfluorescent in the right eye (e) (yellow arrow).
case_images: OC-10-38-g-003.jpg
case_images: PMC7452954_02_OC-10-38-g-003.jpg
case_images: F3
case_images: Spots of chorioretinal atrophy with variable size and "punched-out" appearance were seen in mid-periphery, suggestive of comet lesions (Figure 3a, b (Fig. 3)). Peau d'orange appearance was seen as alternating dark and bright patches on CFP (Figure 3a, b (Fig. 3)) with corresponding hyporeflective and hyperreflective patches on IR (Figure 4b, d (Fig. 4)). Comet lesions of both eyes showed a focal increased fundus autofluorescence (FAF) (Figure 3c, d (Fig. 3)) and a hyperfluorescence on late-phase fundus fluorescein angiography (FFA) (Figure 3e, f (Fig. 3)). The associated comet tail that usually leaves the focal atrophy toward the posterior pole could be seen as hyperfluorescent on FFA in the right eye (Figure 3e (Fig. 3)).
case_images: MC (a, c) of both eyes highlighted AS (black arrows), peau d'orange (arrow heads) and comet lesions (white arrows) clearly. AS was better visualized on IR (b, d) (black arrows). MC (a, c) highlighted peau d'orange in greenish color (arrow heads) which was seen as hyporeflective and hyperreflective patches on IR (arrow heads) (b, d). Comet lesions showed increased signal on IR (b, d), GR (e, g), and BR (f, h) (white arrows).
case_images: OC-10-38-g-004.jpg
case_images: PMC7452954_02_OC-10-38-g-004.jpg
case_images: F4
case_images: AS were seen as dark orange in color on MC (Figure 4a, c (Fig. 4)), and were better visualized in IR (Figure 4b, d (Fig. 4)) as compared to GR (Figure 4e, g (Fig. 4)) and BR (Figure 4f, h (Fig. 4)). Peau d'orange appearance was seen as alternating dark and bright patches on CFP (Figure 3a, b (Fig. 3)) with corresponding hyporeflective and hyperreflective patches on IR (Figure 4b, d (Fig. 4)). MC highlighted peau d'orange in greenish color (Figure 4a, c (Fig. 4)). Comet lesions showed increased signal on IR (Figure 4b, d (Fig. 4)), GR (Figure 4e, g (Fig. 4)), and BR (Figure 4f, h (Fig. 4)).
case_images: SD-OCT of the right eye (a) and the left eye (b) showed comet lesions as irregular hyporeflective spaces with hyperreflective inner border and focal debris like deposits above the retinal pigment epithelium (red arrows).
case_images: OC-10-38-g-005.jpg
case_images: PMC7452954_02_OC-10-38-g-005.jpg
case_images: F5
case_images: On SD-OCT of both eyes (Figure 5a, 5b (Fig. 5)), comet lesions appeared as irregular hyporeflective spaces with hyperreflective inner border and focal debris like deposits above the RPE.