Choroidal neovascularization associated with extensive macular atrophy and pseudodrusen

To describe a case of extensive macular atrophy and pseudodrusen complicated by bilateral choroidal neovascularization (CNV).

A 53-year-old woman showed extensive macular atrophy at the posterior pole associated with disciform scar in the right eye and fibrotic juxtafoveal CNV in the left eye.

The patient underwent a complete ophthalmological examination including fundus autofluorescence, fluorescein angiography, and spectral-domain optical coherence tomography, showing a disciform scar at the posterior pole of the right eye and an extensive macular atrophy associated with a fibrotic juxtafoveal CNV. The patient was previously treated with four and seven intravitreal bevacizumab injections, respectively, in the right eye and in the left eye. Molecular analyses of the ABCA4 gene revealed the variant c.1268A

Although the natural course of extensive macular atrophy and pseudodrusen usually leads to the enlargement of the macular atrophy, extensive macular atrophy and pseudodrusen can also complicate with bilateral CNV. Intravitreal bevacizumab can help stop the CNV activity.