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Year : 2021  |  Volume : 1  |  Issue : 1  |  Page : 21

Hypertrophic sub-retinal scar in neovascular age related macular degeneration

Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India

Date of Web Publication31-Dec-2020

Correspondence Address:
Dr. Samendra Karkhur
Retina, Uveitis and ROP Services, Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal - 462 020, Madhya Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijo.IJO_1908_20

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How to cite this article:
Karkhur S, Soni D, Sharma B. Hypertrophic sub-retinal scar in neovascular age related macular degeneration. Indian J Ophthalmol Case Rep 2021;1:21

How to cite this URL:
Karkhur S, Soni D, Sharma B. Hypertrophic sub-retinal scar in neovascular age related macular degeneration. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 May 15];1:21. Available from: https://www.ijoreports.in/text.asp?2021/1/1/21/305513

A 50-year-old male presented with diminution of vision in right eye (20/200) for two months and previously diagnosed foveal atrophy in left eye. Fundus and Spectralis® (Heidelberg Engineering) spectral domain optical coherence tomography (SD-OCT) examination revealed hypertrophic scar with sub-retinal fluid in right eye which resolved with anti-VEGF treatment and vision improved to 20/60 [Figure 1]a and [Figure 1]b. This is a rare[1] OCT appearance of biconvex, disciform scar-cleaving the RPE-choroid interface with a lamellar cross-section [Figure 1]b. An uncanny resemblance to human crystalline lens could not be overlooked [Figure 1]b. Though, it remains unestablished whether focal choroidal excavation (FCE) is a congenital malformation or an acquired entity, a condition that can lead to choroidal scarring of the macula may result in an acquired form of FCE.[2] Hypertrophic scar in this case with its contractile property might have a role in pathogenesis of acquired FCE.[3] Disciform scars often have photoreceptor layer disruption, which portends a dismal prognosis.[4],[5] The index case presents an interesting scar morphology and good visual outcome owing to preserved photoreceptor layer.
Figure 1: Color fundus photograph of the right eye, showing yellowish-white submacular lesion (a). SD-OCT in enhanced depth imaging mode shows presence of sub-retinal, biconvex, hypertrophic scar, pushing the choroid and RPE simultaneously with a characteristic lamellar appearance in the submacular area in right eye (b)

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

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There are no conflicts of interest.

  References Top

Ferrara D, Silver RE, Louzada RN, Novais EA, Collins GK, Seddon JM. Optical coherence tomography features preceding the onset of advanced age-related macular degeneration. Invest Ophthalmol Vis Sci 2017;58:3519-29.  Back to cited text no. 1
Lee CS, Woo SJ, Kim YK, Hwang DJ, Kang HM, Kim H, et al. Clinical and spectral-domain optical coherence tomography findings in patients with focal choroidal excavation. Ophthalmology 2014;121:1029-35.  Back to cited text no. 2
Ellabban AA, Tsujikawa A, Ooto S, Yamashiro K, Oishi A, Nakata I, et al. Focal choroidal excavation in eyes with central serous chorioretinopathy. Am J Ophthalmol 2013;156:673-83.  Back to cited text no. 3
Gheorghe A, Mahdi L, Musat O. Age-related macular degeneration. Rom J Ophthalmol 2015;59:74-7.  Back to cited text no. 4
Daniel E, Toth CA, Grunwald JE, Jaffe GJ, Martin DF, Fine SL, et al. Risk of scar in the comparison of age-related macular degeneration treatments trials. Ophthalmology 2014;121:656-66.  Back to cited text no. 5


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