LAUSR

A 19-year-old woman presented with a two-week history of metamorphopsia in her left eye. She has been previously diagnosed with a “macular scar” in the left eye, which was consistent with a torpedo lesion in a previous fundus photograph (Fig. 1-A). Her past medical history was unremarkable. The right eye was completely normal on examination. The left eye had corrected visual acuity of 20/30 and intraocular pressure of 13 mmHg. There was no evidence of anterior chamber or vitreous inflammation. In the posterior segment exam of the left eye a creamy gray subretinal lesion was visible on the temporal border of the torpedo lesion (Fig. 1-B). Optical coherence tomography (Spectralis®, Heidelberg, Germany) of the left eye (Fig. 2) revealed an irregular elevation of the retina on the temporal aspect of the fovea by non-homogenous hyperreflective subretinal material demonstrating disruption of the retinal pigment epithelium, interdigitation and ellipsoid zones and preservation of the external limiting membrane (ELM) consistent with a type 2 choroidal neovascularization (CNV.) There was small cleft of subretinal fluid on the foveal side of the lesion. Bruch’s membrane underneath the lesion had an outwardly bowed configuration consistent with choroidal excavation. OCT angiography (Optovue®, Fremont, CA) confirmed the presence of a neovascular frond in outer retina, temporal to the fovea (Fig. 3). The patient was treated with an injection of intravitreal bevacizumab. 2. Discussion