This 89YO male was referred for an asymptomatic retinal tear with possible retinal detachment in his left eye. Vision was 20/60.
Optos color RG imaging shows a red horseshoe-shaped lesion in the temporal midperiphery. Would you recommend immediate thermal laser demarcation of this retinal tear?
We hope not! This patient has asymptomatic and chronic ectopic choroidal neovascularization (CNV), which is evidenced by the more peripheral subretinal scarring and superotemporal dark subretinal blood. 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. The subretinal blood often spontaneously regresses without treatment, although anti-VEGF injections can be used for symptomatic or increasing exudation.
We recommended observation and expect this lesion to remain relatively stable.
