Presumed Polypoidal Choroidal Vasculopathy with Extensive Submacular Fibrosis and Recurrent Subretinal Hemorrhage

A 61-year-old woman with a history of systemic hypertension treated with nifedipine and aspirin 100 mg daily underwent combined phacoemulsification and pars plana vitrectomy in the right eye for cataract and dense vitreous hemorrhage of initially undetermined etiology. This macula-centered color fundus photograph demonstrates a large submacular fibrovascular scar associated with extensive retinal pigment epithelium alterations and multiple areas of subretinal hemorrhage in different stages of evolution. Both chronic and more recent hemorrhagic components are visible within and surrounding the macular region. The clinical appearance was highly suggestive of presumed polypoidal choroidal vasculopathy complicated by recurrent subretinal bleeding and advanced submacular fibrosis.