Home > OCT of the week > 13th March 2022
OCT cases

13th March 2022

This 84-year-old lady presented to her local optometrist with symptoms of a dark spot in the vision from her right eye, which she first noticed inferior to fixation. It had been progressively getting larger and had started to affect her central vision. Her visual acuities were measured as 6/36 right 6/6 left.

This is a single image from an OCT scan of the right macula going from temporal to nasal (left to right – see green arrow) through the fovea.

The most obvious abnormality is subretinal fluid (SRF) in the nasal parafoveal area with some adjacent subretinal hyperreflective material (SRHM) under the fovea. The contour of the inner retina is elevated due to the presence of this material underneath the retina.

The most likely diagnosis is neovascular (wet) age-related macular degeneration. Examination of the left eye revealed drusen but no other abnormality, i.e. early age-related macular degeneration.

This patient was referred for urgent assessment in her local NHS AMD clinic. Treatment with anti-VEGF injections is indicated for the right eye. Lifestyle factors that can have a positive influence on the natural history of AMD, and reduce the risk of development of wet AMD in the fellow eye, should be discussed. AREDS supplements have been shown to reduce the risk of developing wet AMD in the second eye by up to 25%.

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