Maurice F. Rabb » Paracentral Blind Spot And Scotoma

Was first examined in December 1979 because of a history of recent vision loss in the left eye. He was otherwise in good ocular and systemic health.

Visual acuity was 20/20 in each eye uncorrected. There was slight Amsler Grid distortion in the left eye, clear media in both eyes, and bilateral peripapillary choroidal neovascularization. The NV membrane above the right disk was associated with subretinal fluid, lipid, and hemorrhage. The NV membrane above the left disk had a grayish-green component that looked chronic and a reddish component that looked more acute. In addition, subretinal fluid and lipid extended under the left macula and explained the presenting symptom of distortion in the left eye. Angiography was consistent with the clinical findings.

Because both NV membranes were remote from the fovea and because there was no scientific evidence in 1979 that photocoagulation was preferable to no treatment, no photocoagulation or other treatment was performed. Within less than one year, both NV membranes resolved spontaneously.

The patient was re-examined at six month intervals and maintained 20/20 acuity in both eyes. The distortion in the left eye resolved completely although he was left with an enlarged blind spot and paracentral scotoma in the left eye.