CASE REPORT

A 46 year old myopic woman attended the vitreoretinal service with a 3 month history of a shadow in the superior half of her left visual field. Her visual acuity was 6/9 right and 6/12 left, with a refractive error of −13.0D and −9.50D effective spheres respectively.

Examination of the left fundus revealed longstanding detached and thinned retina inferiorly and a broad heavily pigmented demarcation line passing through the macula with associated retinal pigment epithelial (RPE) hypertrophy. An area of parafoveal retina adjacent to the tide mark appeared elevated and a fundus fluorescein angiogram (FFA) revealed a juxtafoveal CNVM emerging from the edge of RPE hypertrophy. Three months later she reported decreased vision and metamorphopsia in her left eye, with a best corrected left visual acuity reduced to counting fingers. A subfoveal extension of the CNVM with bordering haemorrhage was present, confirmed by FFA (Fig 1A, B). She subsequently underwent pars plana vitrectomy, parafoveal retinotomy, and removal of subfoveal CNVM, together with external scleral buckling, argon laser retinopexy, and 20% sulphur hexafluoride gas tamponade.