On spectral-domain OCT of the macula, a 62-year-old man shows a hyporeflective sub-retinal fluid pocket with adjacent retinal pigment epithelium irregularity and no choroidal thickening. The MOST likely diagnosis is:

• A Central serous chorioretinopathy
• B Neovascular age-related macular degeneration ✓
• C Vitreomacular traction syndrome
• D Cystoid macular oedema

Explanation

Sub-retinal fluid with RPE irregularity (RPE detachment/disruption) and no significant choroidal thickening on SD-OCT is characteristic of neovascular (wet) AMD, where choroidal neovascularization elevates the RPE. Central serous chorioretinopathy typically shows sub-retinal fluid without RPE elevation on a background of pachychoroid (increased choroidal thickness). Vitreomacular traction presents with taut posterior hyaloid pulling the fovea; CMO appears as intra-retinal cysts in a petaloid pattern.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.