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52 year old Filipino female with decreased vision OD for two weeks
Digital Journal of Ophthalmology 1998
Volume 4, Number 17
April 18, 1998
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Everett Ai, MD | California Pacific Medical Center, San Francisco, CA
Haris I. Amin, MD | California Pacific Medical Center, San Francisco, CA
Differential Diagnosis
Age Related Macular Degeneration:
ARMD is most often seen in white patients. ItÕs incidence increases with age and a diagnosis of ARMD before age 55 may be some other entity. Drusen and retinal pigment epithelial changes are often seen before the development of exudative features. The vessels of the choroidal neovascular complex are not visible clinically and there is a grey-green discoloration of the membrane. With natural progression there is often a subretinal scar formation. Visual acuity is slowly reduced in the atrophic form of the disease. The exudative form of the disease causes rapid decline in vision.
Idiopathic Polypoidal Choroidal Vasculopathy:
Typically seen in darker skinned individuals; often females in 5th decade onward. Serosanguineous retinal detachments are seen in association with a network of choroidal vessels with polypoid excrescences. Visual acuity is typically good and improves with treatment. There is no associated drusen or scarring.
Central Serous Retinopathy:
Usually seen in males in the third to fifth decades. There is a serous detachment of the retinal pigment epithelium and sometimes the sensory retina. Angiography may SHOW an area of leakage FROM the RPE. There may be an association with steroid use.
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