This 58YO diabetic male was seen originally with mild scattered retinal hemorrhages from nonproliferative retinopathy, along with a faint patch of myelinated nerve fiber layer.
He presented one year later after waking with new nasal field loss. Vision was 20/70, and he had a new, large, superotemporal subretinal hemorrhage just outside the macula.
Following 2 monthly intravitreal Avastin injections, the subretinal blood resolved, with secondary subretinal scarring and yellowing devitalized blood. Vision is 20/60.
Learning Points:
Ectopic choroidal neovascularization (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.
The subretinal blood often spontaneously regresses without treatment, although anti-VEGF injections can be used for symptomatic or increasing exudation.
