Pretty peachy: #OneMinuteOphthalmology
The present case has been reported in the Indian Journal of Ophthalmology.

An 83-year-old Caucasian woman with decreasing vision for 5 years was referred for a macular mass in the left eye (OS). She was a known hypertensive with no other significant systemic complaints. Surgical history included two previous breast biopsies, both of which were negative.

On ocular examination, best-corrected visual acuity was 20/20 in the right eye (OD) and 20/50 OS. Intraocular pressures were normal. She was pseudophakic with bilateral peripheral iridotomies. There was an elevated orange choroidal lesion in the macula (white arrow) and a small choroidal nevus inferiorly OS (black arrow) (a). There was no overlying drusen, hemorrhage, lipid exudation, or edema.

The lesion was 2.65 mm thick and acoustically solid on ultrasonography. Fundus autofluorescence demonstrated central hypoautofluorescence surrounded by a halo of hyperautofluorescence (b). Fluorescein angiography showed early central hypofluorescence surrounded by stippled hyperfluorescence and late ring-like staining. ICGA revealed early hypocyanescence and late geographic hypercyanescence (c).

Optical coherence tomography (OCT) showed a large subfoveal pigment epithelial detachment (PED) and smaller surrounding PEDs without subretinal fluid (d). Heterogenous hyperreflective signals were present along the inner roof of the large PED, and the choroid was flat. A fibrovascular PED associated with age-related macular degeneration (ARMD) was diagnosed and intravitreal bevacizumab was advised.

The final Diagnosis was large fibrovascular PED secondary to ARMD OS.

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