This patient has involuted neovascularization with subretinal fibrosis in the temporal and superotemporal periphery.
The coarse pigment clumping seen throughout the temporal, inferior and nasal retina is pathognomonic for prior resolved subretinal blood.
Fortunately the entire process spares the macular center, leaving the patient with normal central vision.
Learning Points:
Ectopic choroidal neovascularization, also known as peripheral exudative hemorrhagic chorioretinopathy, is a degenerative and exudative process like wet AMD but found in the retinal periphery.
Ectopic neovascularization can appear like a choroidal mass or uveal melanoma and is often misdiagnosed as such. It can also cause subretinal and vitreous hemorrhage.
