Choroidal Neovascular Membrane Research Articles

Effects of slit lamp-delivered retinal laser photobiomodulation in a rat model of choroidal neovascularization

Neovascular age-related macular degeneration, also known as exudative or wet age-related macular degeneration, is the leading cause of blindness in the developed world. Photobiomodulation has the potential to target the up-stream hypoxic and pro-inflammatory drivers of choroidal neovascularization. This study investigated whether photobiomodulation attenuates characteristic pathological features of choroidal neovascularization in a rodent model.Experimental choroidal neovascularization was induced in Brown Norway rats with laser photocoagulation. A custom-designed, slit-lamp-mounted, 670 nm laser was used to administer retinal photobiomodulation every 3 days, beginning 6 days prior to choroidal neovascularization induction and continuing until the animals were killed 14 days later. The effect of photobiomodulation on the size of choroidal neovascular membranes was determined using isolectin-B4 immunohistochemistry and spectral domain-optical coherence tomography. Vascular leakage was determined with fluorescein angiography. The effect of treatment on levels of vascular endothelial growth factor expression was quantified with enzyme-linked immunosorbent assay.Treatment with photobiomodulation was associated with choroidal neovascular membranes that were smaller, had less fluorescein leakage, and a diminished presence of inflammatory cells as compared to sham eyes. These effects were not associated with a statistically significant difference in the level of vascular endothelial growth factor when compared to sham eyes.The data shown herein indicate that photobiomodulation attenuates pathological features of choroidal neovascularization in a rodent model by mechanisms that may be independent of vascular endothelial growth factor.

Two Cases of Massive Subretinal Fluid Accumulation after Photodynamic Therapy for Age-related Macular Degeneration

Purpose: To report two cases of massive subretinal fluid accumulation at laser irradiated sites after photodynamic therapy in patients with age-related macular degeneration (ARMD).Case summary: (Case 1) A patient with bilateral polypoidal choroidal vasculopathy, who was treated with half-dose verteporfin photodynamic therapy (PDT), developed decreased visual acuity. On fundus examination, massive subretinal fluid accumulation was observed in the laser irradiated sites of both eyes. The subretinal fluid was reabsorbed without further treatment, and the patient's visual acuity has recovered. (Case 2) A patient with ARMD, accompanied by a choroidal neovascular membrane and accumulation of subretinal fluid in the right eye, developed decreased visual acuity on the treated eye a day after receiving half-dose PDT treatment. On fundus examination, the subretinal fluid in the right eye had increased more than 5-fold compared to pre-treatment levels. After one week, the amount of subretinal fluid decreased and the patient's visual acuity improved. However, since retinal exudate still remained, intravitreal bevacizumab treatment was administered. Thereafter, the patient’s fundus findings were unremarkable.Conclusions: In the case of photodynamic therapy for ARMD, a large amount of subretinal fluid may occur as a rare complication. The subretinal fluid was naturally absorbed, but close observation is needed with the possibility of developing subretinal fluid in the event of decreased vision after photodynamic therapy.

Demonstrationof CicatricialStagewith Optical CoherenceTomography in A Child with Best VitelliformMacularDystrophy

Best vitelliform macular dystrophy (BVMD) is a rare hereditary macular dystrophy. Various staging systems are performed in the clinical evaluation of BVMD. In this case report, it is aimed to demonstrate the presence of cicatricial stage in a 9-year-old boy. A 9-year-old boy was applied to our Eskisehir YunusEmre State Hospital OphthalmologyClinic with decreased visual acuity in his right eye. When the family history of the patient was questioned, it was learned that the other family members were also followed in another center due to loss of vision. BMVD diagnosis was confirmed by using electrophysiological tests and additional clinical studies. In optical coherence tomography, a hyporeflective lesion consistent with subretinal fluid was observed for both eyes. Additionally, a hump-shaped subretinalhyporeflective lesion was found in the right eye. Visual acuity is generally stable in the early stages of the disease for patients with BVMD, but the presence of a visual impairment is usually thought as a sign of the development of a choroidal neovascular membrane. Although rare, however, cicatricial stage, which is observed in the advanced stages of the disease, can be seen in small children. Distinguishing choroidal neovascular membrane from the cicatricial stage is necessary especially in children due to the risk of amblyopia and to make an accurate treatment planning.

Choroidal Osteoma with Choroidal Neo Vascular Membrane

Choroidal osteoma (CO) is a rare benign tumor usually unilateral and have a female preponderance. We report a case of a 34-year-old healthy malediagnosed with unilateral Choroidal Osteoma with an associated Choroidal NeoVascularMembrane(CNVM).Thediagnosiswasconfirmedbasedonclinicalexamination, typical findings on B-scan, Fundus fluorescein angiography,Indocyanine green angiography and Optical coherence tomography. The CNVMwas treated with intravitreal Bevacizumab injections and showed a good responseinitially.TherewasarecurrenceofCNVMovertwoyearswhenpatientwaslosttofollow-up. Treatmentwith intravitreal Ranibizumab bio similar injection helpedstabilize hisvision. Regular follow-up is essential for timely treatment ofrecurrenceof CNVMand optimum visualoutcomes.

Extension of Choroidal Neovascular Membrane into Subhyaloid Space after Trauma

Extension of Choroidal Neovascular Membrane into Subhyaloid Space after Trauma

Disease-Causing TIMP3 Variants and Deep Phenotyping of Two Czech Families with Sorsby Fundus Dystrophy Associated with Novel p.(Tyr152Cys) Mutation.

We aim to report the ocular phenotype and molecular genetic findings in two Czech families with Sorsby fundus dystrophy and to review all the reported TIMP3 pathogenic variants. Two probands with Sorsby fundus dystrophy and three first-degree relatives underwent ocular examination and retinal imaging, including optical coherence tomography angiography. The DNA of the first proband was screened using a targeted ocular gene panel, while, in the second proband, direct sequencing of the TIMP3 coding region was performed. Sanger sequencing was also used for segregation analysis within the families. All the previously reported TIMP3 variants were reviewed using the American College of Medical Genetics and the Association for Molecular Pathology interpretation framework. A novel heterozygous variant, c.455A>G p.(Tyr152Cys), in TIMP3 was identified in both families and potentially de novo in one. Optical coherence tomography angiography documented in one patient the development of a choroidal neovascular membrane at 54 years. Including this study, 23 heterozygous variants in TIMP3 have been reported as disease-causing. Application of gene-specific criteria denoted eleven variants as pathogenic, eleven as likely pathogenic, and one as a variant of unknown significance. Our study expands the spectrum of TIMP3 pathogenic variants and highlights the importance of optical coherence tomography angiography for early detection of choroidal neovascular membranes.

Retinal injury from a laser skin resurfacing device during medical tourism: a public health concern

BackgroundLaser skin resurfacing is a popular cosmetic procedure for noninvasive skin rejuvenation. Since health insurance plans often do not cover these types of procedures, patients often pay out of pocket. Consequently, there is an incentive to go abroad, where prices are more affordable. However, practitioners in destination countries may lack rigorous training on laser safety, regulatory oversight, or licensing, especially on devices used for “cosmetic” procedures. In certain cases, this can lead to tragic outcomes, especially when underqualified practitioners operate medical-grade laser devices.Case presentationA 29-year-old woman suffered a retinal burn from a handheld Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser pulse device used to perform skin resurfacing treatment at a medical spa in Vietnam. The patient was not adequately informed about the potential risk to her vision and was not provided with any eye protection. A momentary, unintended laser exposure to the patient’s right eye led to irreversible vision loss due to a macular burn. This incident caused immediate pain, followed by the sudden appearance of floaters, along with a retinal and vitreous hemorrhage. Despite treatment with off-label bevacizumab for the development of a choroidal neovascular membrane, vision remained at the level of counting fingers because of the presence of the macular scar.ConclusionWhen utilizing laser-based devices, it is crucial to employ safety measures, such as the wearing of safety goggles or the use of eye shields to protect ocular tissues from potential damage. The growing availability of cosmetic laser devices presents a substantial public health risk, because numerous operators lack adequate training in essential safety standards, or they neglect to follow them. Furthermore, patients seeking services abroad are subject to the regulatory practices of the destination country, which may not always enforce the requisite safety standards. Further research is needed to determine regional and global incidence of laser-related injuries to help direct educational and regulatory efforts.

Preserving visual acuity: a compelling 12-year case study of controlling neovascular age-related macular degeneration

IntroductionIn neovascular age-related macular degeneration (nAMD) trials, anti-VEGF injection frequency decreases after the first year, while outcomes remain primarily related to the number of injections. To the best of our knowledge, there are no reports of maintaining the best corrected visual acuity (BCVA) for more than 7 years in extension studies.ObjectiveTo report a 12-year follow-up of a real-world case of nAMD where BCVA was preserved from declining.Case descriptionA 67-year-old Caucasian female presented to our department in June 2010 due to decreased vision in her left eye (LE) within the preceding months. Examination showed a BCVA of 85 letters (L) in the right eye (RE) and 35 L in the LE. Fundus examination showed drusen in the macula of both eyes. Macular edema, loss of the macular lutein pigment, macular hypo/hyperpigmentation were observed in the LE. A diagnosis of Type 2 choroidal neovascular membrane (CNV) in the LE was established and within two months a Type 1 CNV developed in the RE. She undergone 9 injections of bevacizumab (six) and ranibizumab (three) within the first year of treatment in the LE and seven injections of ranibizumab within the first year in the RE.ResultsThe LE had a mean of 5.2 injections per year, and the RE had a mean of 7.5 injections per year, from 2010 to 2022. RE's BCVA dropped by 8L (85L to 77L) and central retinal thickness (CRT) increased by 16 μm (276 μm to 292 μm) while LE’s BCVA increased by 28L (35L to 63L) and CRT decreased by 369 μm (680 μm to 311 μm), at the twelfth year.ConclusionsAlthough the final visual outcome depends on baseline BCVA and lesion type or size, the number of injections is paramount in preserving BCVA and achieving favorable functional outcomes in nAMD, even after 12 years of treatment.

Evaluation of Photodynamic Therapy-combined Intravitreal Bevacizumab in Age-related Macular Degeneration

Aim: It was aimed to compare treatment results of photodynamic therapy (PDT) and PDT-combined intravitreal bevacizumab injection (PDT+IVB) in patients with age-related macular degeneration (AMD). Material and Methods: 63 eyes of 55 patients with neovascular AMD were included. Group 1 consisted of 40 eyes of 35, group 2 consisted of 23 eyes of 20 patients. Visual acuity (VA), intraocular pressure measurement and fundus examination were performed. Pattern Electroretinography P50 amplitude and edema map values (EMV) were measured with Heidelberg Retina Tomograph (HRTII). Results: VA increased in 14, remained unchanged in 17, decreased in 9 eyes in Group 1 (PDT). The PERG P50 amplitudes were compared with values of pre-treatment, and found increased as 10.6%, 11.98%, and 8.46% and HRTII EMV were 5.86%, 4.88%, and 11.22% at 1st, 3rd, and 6th months, respectively. In Group 2 (PDT+IVB), VA improved in 9, remained unchanged in 8, decreased in 6 eyes. PERG P50 amplitudes were decreased as 10.15%, 5.8%, and 0.1% and HRTII EMV were decreased as 13.07%, 12.17%, and 14.87% at 1st, 3rd, and 6th months, respectively. Conclusion: Verteporfin and PDT are effective and safe methods that preserve VA in subfoveal choroidal neovascular membranes due to neovascular AMD.

Intravitreal Brolucizumab for Chronic Central Serous Chorioretinopathy without Choroidal Neovascular Membrane – a Pilot Study

ABSTRACT Purpose To study intravitreal brolucizumab in the management of persistent macular fluid in chronic central serous chorioretinopathy (CSCR) without choroidal neovascular membrane (CNVM). Methods Retrospective case series which included eyes with chronic CSCR with persistent macular fluid for ≥ 3 months without CNVM. Intravitreal brolucizumab was administered in all eyes. Primary outcome measure was the resolution of intraretinal (IRF) and/or subretinal fluid (SRF) on OCT. Results Five eyes (four patients) with chronic CSCR were included. All eyes showed complete resolution of SRF 1 month following injection. Minimal residual IRF was present in two eyes. Best corrected visual acuity (BCVA) was stable in three eyes, and two eyes showed improvement. Central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) showed reduction. Conclusion Intravitreal brolucizumab is effective in the rapid reduction of persistent macular fluid in chronic CSCR without CNVM. Long-term follow-up data are required to study recurrence and adverse effect profile.

Deep learning-based classification of eye diseases using Convolutional Neural Network for OCT images

Deep learning shows promising results in extracting useful information from medical images. The proposed work applies a Convolutional Neural Network (CNN) on retinal images to extract features that allow early detection of ophthalmic diseases. Early disease diagnosis is critical to retinal treatment. Any damage that occurs to retinal tissues that cannot be recovered can result in permanent degradation or even complete loss of sight. The proposed deep-learning algorithm detects three different diseases from features extracted from Optical Coherence Tomography (OCT) images. The deep-learning algorithm uses CNN to classify OCT images into four categories. The four categories are Normal retina, Diabetic Macular Edema (DME), Choroidal Neovascular Membranes (CNM), and Age-related Macular Degeneration (AMD). The proposed work uses publicly available OCT retinal images as a dataset. The experimental results show significant enhancement in classification accuracy while detecting the features of the three listed diseases.

Bispecific VEGF-A and Angiopoietin-2 Antagonist RO-101 Preclinical Efficacy in Model of Neovascular Eye Disease

ObjectiveTo investigate preclinical data regarding efficacy and biocompatibility of a bispecific protein, RO-101, with effects on Vascular Endothelial Growth Factor-A (VEGF-A) and Angiopoietin-2 (Ang-2) for use in retinal diseases. Study DesignExperimental study. SubjectsBrown Norway rats, New Zealand White Cross rabbits. MethodsPreclinical study data of RO-101 in terms of target-specific ELISA binding affinity to VEGF-A and Ang-2, vitreous half-life, inhibition of target-receptor interaction, laser Choroidal Neovascular Membrane (CNVM) animal model, Human Umbilical Vein Endothelial Cell (HUVEC) migration, and biocompatibility was obtained. Where applicable, study data was compared to other anti-VEGF agents. Main Outcome MeasuresBinding affinity, half-life, biocompatibility, and efficacy of RO-101. Neovascularization prevention by RO-101. ResultsRO-101 demonstrated a strong binding affinity for VEGF-A and Ang-2 and in vitro was able to inhibit binding to the receptor with higher affinity than faricimab. The half-life of RO-101 is comparable or longer than current VEGF inhibitors used in retinal disease. RO-101 was found to be biocompatible with retinal tissue in Brown Norway rats. RO-101 was as effective or more effective than current anti-VEGF therapeutics in causing regression of neovascular growth in vivo. ConclusionRO-101 is a promising candidate for use in retinal diseases. In preclinical models, RO-101 demonstrated similar or higher regression of neovascular growth to current anti-VEGF therapeutics with comparable or longer half-life. It also demonstrates strong binding affinity for VEGF-A and Ang-2. It also was shown to be biocompatible with retinal tissue in animal studies, indicating potential compatibility for use in humans.

Longitudinal Characteristics of Choroidal Neovascular Membrane in Pediatric Patients

To report the clinical and imaging characteristics, including optical coherence tomography angiography (OCTA), and treatment outcomes of choroidal neovascular membranes (CNVMs) in children. Retrospective clinical cohort study. Thirty eyes from 25 children (56% girls) with CNVM from 2 centers were examined from 2005 to 2022. Clinical features, imaging findings, treatment regimens, and outcomes are described. The most common causes of CNVM were idiopathic (48%) and inflammatory (20%). At diagnosis, most CNVMs were unilateral (80%), active (83.3%), and juxtafoveal (46.7%). Twenty-five eyes (83.3%) of 21 patients (84%) were treated. The most common first-line treatment was intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) (92%), with a retreatment rate of 52.2% at an average of 237 days. The average number of total injections per eye was 2.3. Injections were safely administered in the clinic (52.2%). A gain of 3 lines or 15 ETDRS (Early Treatment Diabetic Retinopathy Study) letters was observed at final visit. The average duration of follow-up was 56.46 ± 42.51 months. No ocular or systemic complication related to treatment was reported. Sixteen eyes (64%) had OCTA images at both presentation and final visit, which showed a decrease in CNVM vessel density and vessel-length density, and in the height of retinal pigment epithelium detachment (RPED). There are a variety of underlying etiologies for pediatric CNVMs, which are most often unilateral. Treatment with intravitreal anti-VEGF can be beneficial and does not often require frequent or chronic dosing. OCTA demonstrated a decrease in the CNVM vessel density and vessel-length density as well as in the height of RPED.

EVALUATION OF VISUAL OUTCOME AND CLINICAL RESPONSE OF INTRAVITREAL ANTI VEGF AGENTS IN VARIOUS INDICATIONS

Objectives: The aim of the study was to evaluate efficacy of ranibizumab and aflibercept in Choroidal neovascular membrane (CNVM) and chronic macular edema secondary to diabetes mellitus and retinal vein occlusion in the Central India population. Methods: The present study was a prospective and observational study conducted among patients attending the outpatient department, and retina clinic were grouped as per various indications of anti-vascular endothelial growth factor (anti-VEGF) treatment. Patients were then followed up on day 7, 1-month interval during which visual acuity assessment, fundus examination, and optic coherence tomography was done to measure central retinal thickness which was compared with baseline data. Results: Two different anti-VEGF agents were used among study participants. Out of 43 study participants, ranibizumab was given in 32 (74.4%) of which seven patients had age-related macular degeneration (ARMD), four had myopic CNVM, 14 had diabetic retinopathy (DR), and seven had macular edema – secondary to retinal vein occlusion. Aflibercept was given in 11 (25.6%) of the study participants, of which six had DR, four had CNVM-Myopia, and one patient had macular edema – secondary to retinal vein occlusion. Conclusion: In our study, both anti-VEGF agents showed significant reduction in central macular thickness (CMT) after every injection. Our study suggests that Aflibercept is more effective in reducing CMT.

A rare case of very late recurrence of CSCR-induced CNVM following intra-articular injection of depot steroid

Choroidal neovascular membrane (CNVM) is a major cause of long-term vision loss in patients with chronic central serous chorioretinopathy (CSCR). External steroid medications, both oral and injectable, have long been proven as one of the major contributors to CSCR pathogenesis. Here, we report an old case of CSCR with CNVM, who presented with reactivation of CSCR and CNVM, 6 weeks following intra-articular steroid injection for chondromalacia patellae after an unusual gap of 8 years. Exposure to high doses of steroids can be a significant risk factor for reactivation of CSCR CNVM in susceptible individuals, even after a long disease-free interval. The disease process responded well to intravitreal anti-vascular endothelial growth factor (anti-VEGF; ranibizumab) treatment with good visual and anatomical outcomes.

Role of optical coherence tomography angiography in diagnosis and management of inflammatory choroidal neovascular membrane in multifocal choroiditis – A case report

A 32-year-old male presented with decreased vision in the left eye. Fundus examination revealed healed multifocal choroiditis (MFC) and a juxtafoveal subretinal bleed. Optical coherence tomography (OCT) revealed streak subretinal fluid (SRF) and subretinal hyperreflective material (SHRM) at the macula. Fluorescein angiography (FA) showed a small area of faint hyperfluorescence adjacent to a choroiditis scar, amidst background scarring. Optical coherence tomography angiography (OCTA) detected type 2 choroidal neovascular membrane (CNV). A detailed clinical examination with appropriate ancillary imaging helps in detection of inflammatory CNV. OCTA may be superior to FA in detection of these neovascular membranes in certain case scenarios.

Intravitreal bevacizumab in choroidal neovascularisation in Vogt‐Koyanagi‐Harada disease in a child: A review of literature

Aims/Purpose: Interest of bevacizumab in children in the treatment of choroidal neoplasms in Vogt Koyanagi Harada syndrome.Methods: In this work we report the case of an extra‐foveal choroidal neovascularization in a child followed for VKH syndrome with a good response to intravitreal injections of bevacizumab.Results: We report the case of a 12‐year‐old child who initially presented to the hospital in 2020 for bilateral decreased visual acuity and headache. There was no history of systemic disease. Initial visual acuity was 1/10 in both eyes. Biomicroscopic examination revealed granulomatous retrodescemetic precipitates, 2× anterior chamber tyndall, 1× vitreous tyndall, and bilateral exudative retinal detachment associated with bilateral papilledema in both eyes. Based on these findings, a diagnosis of Vogt‐Koyanagi‐Harada syndrome was made, and treatment was initiated with intravenous, oral, and topical corticosteroids. Visual acuity improved to 6/10 OD and 7/10 OS the following month. The patient was then followed up at the university hospital regularly. After controlling the inflammation, steroids were decreased over a period of 2 years but the patient relapsed at high dose to declare cortico‐dependence. Anti‐TNF alpha was started to control the inflammation and visual acuity remained stable until July 2022. Choroidal neovascularization then developed, reducing the patient's visual acuity to 3/10 in both eyes within 1 month. Fluorescein angiography and macular OCT confirmed the diagnosis of extrafoveolar choroidal neovascularization in both eyes. After obtaining informed consent, intravitreal bevacizumab was injected 3 times at 6 week intervals in each eye. After the 6th injection, the patient's best‐corrected visual acuity improved to 8/10 in the right eye and 10/10 in the left eye. The fundus photograph illustrates the regression of the choroidal neovessels. Fluorescein angiography confirmed the reduction in leakage. Choroidal neovascular membranes can cause severe visual impairment and are a major challenge in the management of patients.Conclusions: This case illustrates that intravitreal bevacizumab has a possible role in the treatment of the disease, with regression of neovascular lesions in the eye.

Assessment of Choroidal Neovascular Membrane by Optical Coherence Tomography Angiography

Assessment of Choroidal Neovascular Membrane by Optical Coherence Tomography Angiography

Calcified Sclero-Choroidal Choristomas in Mosaic RASopathies: A Description of a New Imaging Sign

PurposeTo evaluate the imaging and clinical features of unusual calcified lesions seen in the fundus of mosaic RASopathy patients. DesignSingle-center retrospective observational study. SubjectsTen eyes with calcified fundus lesions in 7 mosaic RASopathy patients. MethodsThe lesions were evaluated with fundus photography, oral fundus fluorescein angiography, B-scan ultrasonography, Magnetic Resonance Imaging (MRI), and Computed Tomography (CT) scan where available. Main Outcome MeasuresThe imaging characteristics of calcified fundus lesions were assessed. ResultsWe found seven patients with mosaic RASopathies, 5 males and 2 females (3 with Linear Sebaceous Nevus Syndrome, 3 with Oculoectodermal Syndrome, and 1 with Encephalocraniocutaneous Lipomatosis) with molecular confirmation in 5 cases, all 5 having KRAS-pathogenic variants. Calcified fundus lesions were identified in 10 eyes (bilateral in 3 patients), appearing as slightly elevated, creamy-yellow lesions around or adjacent to the optic nerve, extending supero-nasally; all but two of these lesions involved both the choroid and sclera, with two of them only involving the sclera at the time of examination. One case developed a choroidal neovascular membrane (CNV) necessitating intravitreal bevacizumab injections. All 7 patients had B-scan ultrasonography and the lesion appeared as a hyperechogenic area with an acoustic shadow posteriorly despite reduced gain. Five patients had MRI, and where fundus lesions were present, there was a focal defect in the sclero-choroidal layer. Four patients had a CT scan and all four showed calcifications affecting both the posteromedial sclero-choroid and adjacent medial rectus muscle. Two of these patients had normal eye movements, one had a unilateral fixed adducted eye and a vestigial fibrous medial rectus muscle seen in imaging and intraoperatively, and the fourth had marked exotropia with a right gaze deficit affecting both eyes. ConclusionsWe propose that the lesions seen in this cohort are calcified sclero-choroidal choristomas (CaSCCs) and should be suspected in mosaic RASopathies when creamy-yellow lesions are seen in the fundus. If identified, the possibility of choroidal neovascularization should be considered during follow-up. In all cases where a CT scan was performed, a novel sign of sclero-muscular calcification involving the medial rectus muscle was seen.

Bilateral choroidal neovascular membrane in multifocal serpiginoid choroiditis in young children - Case report of two patients with swept-source optical coherence tomography angiography correlation

We present two cases of bilateral multifocal serpiginoid choroiditis (MSC) in young children with latent tuberculosis infection. Vitritis was seen in both cases. Multiple recurrences were noticed over regular follow-up visits. Anti-tubercular treatment was advised along with oral corticosteroids and immunomodulatory drugs for better remission. Swept-source optical coherence tomography angiography (SS-OCTA), used for monitoring disease activity, showed the development of bilateral choroidal neovascular membrane in both cases due to long-standing choroidal inflammation. Intravitreal anti-VEGF was administered for the regression of the neovascular membrane. MSC in the younger age group is a rare occurrence. This case highlights the importance of SS-OCTA and regular follow-up.