Case of the Month | May 2019

The patient was a 91 year old man without acute visual complaints. He was seen for a second opinion regarding treatment on the left eye, and he sometimes noticed that images seemed slanted when using the right eye. The left eye had an Avastin treatment elsewhere one month ago for wet age-related macular degeneration. He was found on our examination to have a single parafoveal intraretinal hemorrhage in the left eye. He had no complaints with respect to the right eye. The visual acuity was 20/25-2 OD and 20/100 without correction, pin hole 20/50, J1 OS. Both eyes were pseudophakic without posterior capsular opacity. There was a Weiss' ring in the right eye and the left eye was status post vitrectomy. There appeared to be tiny dots on the surface of the right macula. In the left macula, there was a superficial sheen and there was a single parafoveal intraretinal hemorrhage. The fundus photograph and fluorescein angiogram of the right eye were unremarkable. The OCT of each eye and the FA of the left eye are attached. What was the most likely diagnosis? What treatment, if any, would you recommend?