Extensive Macular Atrophy with Pseudodrusen Imaged with OCT Angiography

Area of Science:

• Ophthalmology
• Medical Imaging

Background:

• Extensive macular atrophy with pseudodrusen (EMAP) is a rare clinical entity.
• Understanding its pathogenesis is crucial for diagnosing and treating macular degenerations.

Observation:

• A 58-year-old man experienced decreased central vision.
• Fundus examination revealed macular atrophy and diffuse reticular pseudodrusen.
• Spectral domain OCT (SDOCT) showed outer retinal and choriocapillaris atrophy.

Findings:

• Optical coherence tomography angiography (OCTA) revealed a marked absence of choriocapillaris blood flow.
• This is the first reported OCTA imaging of EMAP.
• The imaging demonstrated severe compromise of the choriocapillaris.

Implications:

• EMAP represents an extreme phenotype of macular degeneration.
• This case sheds light on the role of pseudodrusen and choriocapillaris compromise in AMD pathogenesis.
• OCTA may be valuable for assessing the severity and progression of EMAP.