A 17-year-old female presented with metamorphopsia and blurred vision in right eye (OD) since 1 week. Her best corrected visual acuity (BCVA) was 6/9;N8 in OD and 6/6;N6 in left eye (OS). Clinical examination revealed findings suggestive of choroidal neovascular membrane (CNVM). Her spectral-domain optical coherence tomography (SD-OCT) showed an active Type 2 CNVM associated with a FCE, which was confirmed by fundus fluorescein angiography (FFA). She was treated with multiple intravitreal antiVEGF injections. At her follow-up visits there was significant CNVM resolution, but FCE was progressively increasing in depth, as measured from a horizontal line drawn at the level of RPE to the inner margin of FCE, from 121 μm to 256 μm over the period of 2 years, possibly due to the contraction of the underlying scar [].
A 28-year-old female patient presented with metamorphopsia in her left eye starting 2 days earlier. There was nothing of note in her medical or family history, and her visual acuity was 1.0 in the right eye and 0.8 with -5.0 D refraction in the left eye. Anterior segment examination was normal. Fundus examination was normal in the right eye, but macular pigmentary alterations were observed in the left eye (). On FFA there was hyperfluorescence beginning in the early phases and increasing in the late phase, which was more suggestive of choroidal neovascular membrane (CNVM) than CSCR (). Although it is recommended for a definitive diagnosis, ICGA was not done. Despite smooth foveal contours in the left eye on OCT, an area of subfoveal focal choroidal excavation and overlying hyporeflective subretinal fluid were detected (). The lesion in the patient’s left eye was accepted as CNVM and an intravitreal bevacizumab injection was administered. At follow-up 1 month later, the patient’s symptoms had improved, vision in her left eye improved to 0.9 and the hyporeflective area evident on OCT had decreased in size. At 2-year follow-up, visual acuity in the left eye was 0.8 and persistent RPE changes were observed on fundoscopy (). Hyperfluorescence which increased slightly in the late phases was observed on FFA of the left eye (). On OCT, the focal choroidal excavation remained unchanged, the overlying hyporeflective area had resolved and the photoreceptor layer appeared continuous ().