AMD DEHGHANI.A

Soft drusen Classic CNV Occult CNV Fibrovascular pigment epithelium detachment Retinal angiomatous proliferation Polypoidal choroidal vasculopathy

SOFT DRUSEN Localized multiple elevation of the hyper- reflective band of the retinal pigment epithelium-bruch's membrane- choriocapillaris complex With no shadowing backwards to choroid Neither any sub-retinal nor intra-retinal fluid accumulation The different retinal layers remain normally organized

GEOGRAPHIC ATROPHY A decrease in thickness of the neurosensory retina A disappearance of the hyporeflective band corresponding to the photoreceptors An increased hyper-reflectivity of the retinal pigment epithelium-Bruch's membrane- choriocapillaris extending back towards the underlying choroid

CLASSIC CNV direct exudative symptoms indirect exudative symptoms

Direct Exudative Symptoms:  a hyper-reflective,fusiform area of thickening, above and adjacent to the RPE  The shadowing underneath the RPE towards the choroid

Indirect Exudative Symptoms:  increase of thickness of the sensory retina due to intra-retina fluid accumulation  flattening of the foveal depression  Detachment and elevation of the neurosensory retina  RPE detachment (serous or hemorrhagic)

OCCULT CNV A hyper-reflective thickened band confounded with the RPE usually irregular and sometimes fusiform (cigar-like) with shadowing towards the choroid RPE detachment Sub-retinal and/or intra-retinal accumulation of serous fluid with or without intraretinal cystoid edema

FIBROVASCULAR PIGMENT EPITHELIUM DETACHMENT A thicker hyper-reflectivity notch appended on the choroidal side of the elevated retinal pigment epithelium might represent CNV

RETINAL ANGIOMATOUS PROLIFERATION Deep retinal neovascularization The retinal neovascularization eventually communicates with the subretinal and choroidal space Choroidal neovascularization is present in late-stage RAP

A distinct form of occult CNV associated with proliferation of intraretinal capillaries in the paramacular area

POLYPOIDAL CHOROIDAL VASCULOPATHY A unique form of occult choroidal neovascular membrane

1. A branching network of inner choroidal vessels 2. Terminal, aneurysmal dilations of the vessels 3. Subtle nodular choroidal protrusions 4. Serosanguineous retinal pigment epithelial detachments 5. Exudative retinopathy 6. Vitreal hemorrhage 7. Chronic and recurrent course

Prognosis Generally good, provided the macula is not involved

Conclusion: Helping in categorization Picking up the associated secondary changes Monitoring response to the therapies

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