Figure 1.

Gradual enlargement of peripheral hemorrhagic pigment epithelial detachment (PED) in the right eye of a 74-year-old woman. A. Color fundus photograph shows a pigmented choroidal nevus with overlying drusen and two small hemorrhagic PEDs below the nevus. B. Optical coherence tomography (OCT) shows a small PED. C. Fluorescein angiography shows focal blockage of underlying choroidal fluorescence and two areas of hyperfluorescence corresponding to the location of the ophthalmoscopically visible PEDs. D. Indocyanine green angiography reveals the presence of polypoidal choroidal vessels corresponding to the location of the PEDs. E. Fundus photograph 11 months after initial evaluation and two months after standard photodynamic therapy. F. Four months later the hemorrhagic PED is significantly larger. G. OCT shows large PED with optically dense material inside. H. Four months later and after two monthly injections of intravitreal bevacizumab, the PED is larger and contains old blood. Note the presence of mild fresh and old subretinal hemorrhage at the superior and posterior margin of the PED.