Good Hope Eye Clinic

Case 20 wet armd:
right large PED,
left nsd & small ped

David Kinshuck

Abbreviations

  • ped=pigment epithelial detachment
  • NSD=neurosensory retinal detachment
  • armd=age-related macular degeneration

Patient

History

  • 1935  date of birth, female

2009

  • Right wet age macular degeneration (armd). Treated with lucentis (visual outcome 6/36).
    A large PED remains as below.

2010

  • Left wet armd.
    The patient was being followed up as she had had Lucentis in the right eye, and did not complain of any visual disturbance in this left eye. She had developed wet age macular degeneration. This was therefore a chance finding.
    The before and after treatment scans are shown below, with a fantastic response to lucentis, resulting in a normal retinal appearance. Vision 6/9 before lucentis, 6/7.5 afterwards.
    She will be followed up for the next few years, with a scan approximately every month. Further lucentis will be offered if the fluid returns.

PEDs

  • See. The pigment layer detaches. This is often associated with a network of blood vessels. The recommended teatment of these is depends on certain factors.
    This patient's left eye is a straightforward case...sudden loss of vision, ped/nsd, and treatment is strongly recommended.
  • Large PEDs, such as that in this patient's right eye, do not respond well to treatment. A small persnetrage 'rip' when given antiVEGF treatmment.

 

Right eye

a large PED (pigment epithelial detachment

This OCT scan shows 2 cuts through the right macula. The left photo/scan above shows the cut below the fovea and demonstrates a very large PED. The right photo/scan above shows a cut through the fovea, with nearly flat retina.

 

Left eye

wet macular degeneration with a combined  NSD (neurosensory detachment) and PED (pigment epithelial detachment, a very common appearance

a diagram showing wet armd with a ped and nsd

The scan of the left eye before and after Lucentis. The scan is explained in the diagram above