Peripheral Disciform Degeneration: A Diagnostic Challenge

Peripheral disciform degeneration is a rare condition that presents significant diagnostic challenges due to its varied nomenclature and ability to mimic other ocular pathologies, such as choroidal melanoma. An 81-year-old female with longstanding poor vision in her right eye experienced progressive visual deterioration in her only functioning left eye. She underwent urgent evaluation in the eye casualty, followed by further assessment by the medical retina and ocular oncology teams to rule out the possibility of malignancy. Clinical examination and imaging revealed sub-foveal fluid and a hemorrhagic pigment epithelial detachment in the superotemporal quadrant, with angiography demonstrating blocked fluorescence. Based on these findings, a diagnosis of peripheral disciform degeneration was established. Given the presence of sub-foveal involvement, treatment with intravitreal bevacizumab was initiated. A one-month follow-up revealed complete resolution of sub-foveal fluid and an improvement in vision to baseline. This case highlights the importance of increasing awareness of this condition to ensure accurate diagnosis and guide appropriate management, particularly when malignancy is a concern.