67 year old with diminution of vision in right eye since 6 months. No history of DM/HTN. Taking treatment for open angle glaucoma OU brimonidine 0.15%BD Examination OD FC 2m OS 6/36 Fundus picture ,FFA and OCT attached 1. diagnosis 2. line of management



RE: CNVM LE: Partial thickness macular hole CNVM can be managed by Inj Anti -VEGF or laser. Medically treatment is not encouraging but AREDS formulation can be given along with. Lamellar macular hole can be left as it is. PPV+fluid-gas exchange can be done in progressive condition.

CNVM in the right eye and lamellar macular hole in the left. Glaucomatous disc damage more in the left eye (bipolar rim thinning). Right eye needs Anti VEGF Intravitreal injection. Don't do anything for the lamellar hole just yet.. keep the patient on regular followup. Has trabeculectomy been performed in this patient?If not, Is brimonidine alone enough to control the glaucoma?

RE - CNVM. Considering the age, it could most probably be Wet ARMD. Since macular area is involved, we can try Anti-VEGF or Verteporfin therapy LE- Partial thickness macular hole. Can wait and watch. If vision don't improve (considering patient not having cataract), we need to go forward with PPV + Intravitreal Gas tamponade

RE though disc findings are not very clearly seen in pic, definitely LE has more glaucomatous damage compared to RE with superior notch.. RE CNVM LE 0.8 Cup with superior notch with lamellar macular hole.. RE intravit inj anti VEGF LE Evaluation for glaucoma and better opt surgical management, for lamellar hole -- WATCH

Re: CNVM with le: lamellar macular hole with CD ratio 0.8:1... management: glaucoma work up.. re antivegf and AREDS formulation le observation

it is cnvm requires intravitreal anti vegf injections

get an ICG done first looks like ipcv

od macular hole os cnvm



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Right high cnvm with scarring as history also suggests six months and leakage is also not there in later phase..so i dont think anti vegfs wil not help him anymore.. Left eye had partial thickness macular hole which has to b kept under follow up

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