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Subretinal hemorrhage case report

A 75 years old male with reduced vision OS to counting fingers with a history of one intravitreal injection of aflibercept


Fundus image


The fundus image shows subretinal blood with druses and elevated retinal tissue.


Fundus image shows subretinal hemorrhage
Fundus image shows subretinal hemorrhage 



Optical coherence tomography 


OCT scan shows the following

the red arrows show both pigment epithelium detachment (PED) and visible Bruch's membrane, a double layer sign with dilated Haller's and thickened choroid that indicates a pachychoroid.


In this case, PED with heterogenous content, while the blue star shows subretinal hemorrhage, but the blue arrow shows subretinal fluid. Another finding in this OCT scan is the disturbed ellipsoid zone with no intraretinal fluids.


OCT cross-section showing PED with subretinal hemorrhage
OCT cross-section showing PED with subretinal hemorrhage 


Discussion

 

The Differential diagnosis here is occult neovascular ARMD or polypoidal chorioretinopathy.


This case is best managed with intravitreal injection of AntiVEGF. In cases of treatment failure, pneumatic displacement is considered with or without intravitreal tPA.


Please drop a comment below on how you would handle this case??.


Please check Clinical guidelines for ARMD 

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Comments

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