Maurice F. Rabb » Active Choroidal Neovascularization With Subretinal Hemorrhage

This 42 year old female was referred by her ophthalmologist as an emergency after he saw her earlier that day on 9/18/93, with a history of blurred vision of one month's duration in the right eye. Past medical history was completely negative, but the blood pressure was 220/120 at our office.

Vision: 20/20 OU for distance
20/70 OD and 20/100 OS for near.

Peripheral fields are full to confrontation.

Pupils, extraocular movements, tension by applanation and slit-lamp examinaiton was normal in both eyes.

Amsler grid is normal in the left eye, but grossly abnomal in the right eye with distortion superiorly.

Fundus exam showed immediately below the fovea active choraoidal neovascularization with some subretinal hemorrhage. In both eyes, fairly symmetrically, there were cream-colored lesions most prominent nasal to the disc. There were definite vitreous cells present. The lesions looked fairly typically for birdshot retinochoriodopathy. There were sparse areas of perivasculitis.

The fluorescein angiogram showed obvious juxtafoveal choroidal new vessel membrane below the right fovea.

Laser therapy was accomplished with the red followed by the yellow wavelength of the tunable dye laser.

HLA-A29 was positive.