Título / Title

LARGE COLOIDAL DRUSEN AND CHORIORETINAL SCAR: AN UNCOMMON CONDITION

Introdução / Purpose

To describe the uncommon concomitance of two ocular conditions in an early age man: chorioretinitis scar and large colloidal drusen (LCD).

Material e Método / Methods

Case report.

Resultados / Results

A 37-year-old white man, from São Paulo, Brazil, rural worker, has presented with the main complaint of unilateral severe vision loss in the right eye for 9 years. His ophthalmological and family history were both unremarkable. His BCVA was counting fingers on the right eye (OD) and 20/20 on the left eye (OS). Anterior segment biomicroscopy was unremarkable. There was no afferent pupillary defect. Fundus examination showed multiple sub retinal yellowish lesions temporally to the macula in both eyes. A chorioretinitis macular scar was noticed near to the optic disk in the OD. The FFA showed inferior arterial filling delay, early hyperfluorescence of the drusen in the OD. The druse was showed on OCT B-scan as a convex form with moderate internal homogeneous reflectivity, intense attenuation of the elipsoid zone above the drusen and RPE atrophy. No treatment was needed and the patient was advised to have eye exams on a regular basis.

Discussão e Conclusões / Conclusion

Drusen is a deposit located between the RPE and the Bruch membrane. When appears before 50 years old it may present as cuticular drusen, Malattia Leventinese and LCD. LCD is more frequent in women, measuring approximately 200 to 300µ, bilateral with pale yellowish aspect and hyperpigmented border. Although it is usually in the posterior pole, it may occur beyond the equator and temporally to the macula. It has no genetic inheritance stablished. In the OCT it is usually described as convex structures with moderate internal homogeneous reflectivity and overlapped intense attenuation of the elipsoid zone besides hyperreflective halos (donut effect) in the en face OCT. FFA shows homogeneous hyperfluorescence in the final phase. The prevalence of CNV is not well stablished, but it is significantly lower than in AMD.

Palavras Chave

Retinal Drusen; Eye Diseases; Choroidal Neovascularization.