Ophthalmology · Ophthalmic Imaging and Investigations (OCT, FFA, B-scan, Perimetry, Biometry, Topography)

A 70-year-old patient with wet age-related macular degeneration undergoes swept-source OCT (SS-OCT). The image reveals a shallow irregular RPE elevation with a 'double-layer sign' (two hyperreflective bands separated by a hyporeflective space beneath the RPE). This finding is most characteristic of:

  • A Polypoidal choroidal vasculopathy (PCV)
  • B Retinal angiomatous proliferation (RAP)
  • C Type 3 choroidal neovascularization
  • D Pachychoroid neovasculopathy
Correct answer: A. Polypoidal choroidal vasculopathy (PCV)

Explanation

The double-layer sign (Bruch's membrane and RPE separated by a hyporeflective space) is characteristic of PCV on SS-OCT. It represents the branching vascular network and polypoidal lesions beneath the RPE. RAP shows intraretinal neovascularization; type 3 shows outer retinal CNV; pachychoroid shows thickened choroid without the double-layer sign.

Reference: Ryan's Retina, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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