This 80YO male had 20/80 vision in his left eye with ongoing Eylea injections for wet age-related macular degeneration (AMD). Vision was hand motion in his right eye due to an inactive disciform scar.
Several months ago, he complained of decreased vision OD and was found to have a dense vitreous hemorrhage. About 6 weeks later, he underwent vitrectomy in this eye to try to restore his peripheral vision.
One day postoperatively, Optos photography showed the residual vitreous skirt, subretinal blood, and elevated choroidal/suprachoroidal yellow blood.
Learning Points:
Ectopic choroidal neovascularization (CNV), also known as peripheral exudative hemorrhagic chorioretinopathy, is an exudative process similar to wet AMD but located in the retinal periphery.
Ectopic CNV can often masquerade as a choroidal mass or uveal melanoma. It can also cause extensive choroidal/suprachoroidal, subretinal, and vitreous hemorrhage, more commonly in patients who are on blood thinners (our patient was on Pradaxa).
The subretinal blood often spontaneously regresses without treatment, although anti-VEGF injections can be used for symptomatic or increasing exudation.
