An 85-year-old woman presents with a 2-month history of vision loss. You obtain an OCT.
What abnormalities are noted on the OCT?
The presence of an epiretinal membrane
An epiretinal membrane can be seen in many patients with AMD, but there is no association (both are simply common lesions seen in the elderly). If located, it is seen on the surface of the retina. It may or may not be associated with retinal distortion and macular hole formation.
Hyperreflectivity consistent with exudation
Exudate due to lipoprotenacous material depositing in the retina is very hyperreflective and may be associated with deeper retinal shadowing. This can uncommonly be seen in patients with CNV, but is more commonly seen in patients with diabetic macular edema and retinal vein occlusion.
There is the presence of a thin hyperreflective band anterior to the RPE. This represents a classic CNV (demonstrated on angiography).
A retinal artery occlusion
In a patient with retinal artery occlusion (in the acute phase), there is the presence of inner retinal hyperreflectivity, a middle limiting membrane and deeper retinal shadowing.