Fig. 2

Case 2. A Baseline autofluorescence of both eyes demonstrates no significant RPE changes in the OD and, in the left eye, shows focal hypo-autofluorescent dots in the posterior pole, including the macula, and forming a descending tract. B Baseline spectral domain optical coherence tomography (SD-OCT) of the OS reveals foveal subretinal fluid. In the nasal macular region, there is outer retina and RPE atrophy, associated with intraretinal and subretinal fluid. C–E 31 months after baseline, and 1 week before metoprolol injection. C Fluorescein angiography reveals transmission hyperfluorescence in the areas corresponding to the RPE changes on autofluorescence. There are also small hyperfluorescent dots surrounding the foveal area, which corresponded to short-pulse laser burns. OS Indocyanine green angiography demonstrates areas of hyperfluorescence secondary to RPE changes and choriocapillaris hyperpermeability in the early and late phases. D Optical coherence tomography angiography of the OS shows no signs of choroidal neovascularization. E Spectral domain optical coherence tomography (SD-OCT) of the OS before intravitreal metoprolol demonstrates outer retinal atrophy and RPE defects in the foveal area associated with chronic cystoid macular edema. F SD-OCT of the OS five weeks after metoprolol injection shows a significant reduction of the intraretinal fluid