This 70YO male presented with counting fingers vision in his right eye due to a large disciform scar with radiating inner retinal folds. The radiating folds appear as corrugations on OCT B-scan and as radiating lines on OCT en face.
Learning Points:
Disciform scars were the norm for untreated wet AMD prior to the anti-VEGF era that began in the mid-2000s. New-onset wet AMD diagnosed and treated with appropriate anti-VEGF dosing virtually never goes on to develop these lesions.
There may be progressive macular atrophy following years of therapy, but not this type of fibrotic scarring.
The radiating folds in our patient are caused by contraction of the fibrosed macular neovascularization which is centripetally dragging the overlying neurosensory retina.
