Dr.Muna Bhende, B10263
There is a continuous search for biomarkers that indicate the presence of CNV and predict response to therapy. We describe 4 eyes in which the significant clinical finding was subretinal fibrin and mild disturbance in vision . None showed CNV, PED , SRF or haemorrhage . OCT showed subretinal hyper reflectivity overlying a localised PED in 2 eyes and more extensive irregular RPE elevation in 2 eyes. All eyes had RPE disruption on OCT . In 2 eyes with suspected inflammatory lesions and localised RPE elevation, there was no CNV on angiography or OCT , but both developed drop in vision due to active CNV and subretinal hemorrhage less than a month later. In 2 eyes , ICG and OCTA showed type 1 CNV below the fibrin at the time of presentation. All eyes underwent treatment with intravitreal antiVEGF . The unexplained presence of subretinal fibrin can be a biomarker for the presence of, or indicator for development of CNV. Close followup and ICG and /or OCTA are warranted in these cases.
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