What brings you in today? (continued)

In continuation of yesterday's post, included is the patient's photos from approximately 2 1/2 years before. As was correctly pointed out in the comments, this patient was relying on her left eye for nearly all of her vision. It was the acute change in her better eye that prompted her to notice a change in her vision. The image shows a striking example of the natural progression of AMD, the leading cause of blindness in American adults. The fundus of the right eye is remarkable for the large disciform scar which represents the end stage of choroidal neovascularization (CNV) and wet (or exudative) age related macular degeneration. Now that we live in the era of anti-VEGF injections, advanced disciform scars like this will hopefully be a thing of the past. The left eye was likely still dry in the first set of images. The characteristic finding of advanced dry (nonexudative) AMD that can be seen is the significant geographic atrophy (GA) representing degenerative changes to the pigment epithelium (RPE). Unfortunately, the acute changes resulting in a loss of vision were the result of a hemorrhage heralding the transformation from dry AMD to wet. Stay tuned for more examples of AMD as it is one of the most important disease entities affecting the retina.