Differential Diagnosis for Active Monocular Choroidal Neovascular Membrane of the Macula
- Single Most Likely Diagnosis
- Age-related macular degeneration (AMD): This is the most common cause of choroidal neovascularization (CNV) in older adults, characterized by the growth of new, fragile blood vessels under the macula, leading to vision loss.
- Other Likely Diagnoses
- Pathologic myopia: High myopia can lead to stretching and thinning of the retina, increasing the risk of CNV.
- Ocular histoplasmosis syndrome: A condition caused by exposure to the fungus Histoplasma capsulatum, which can lead to CNV.
- Angioid streaks: Breaks in the Bruch's membrane, often associated with systemic conditions like pseudoxanthoma elasticum, can lead to CNV.
- Traumatic choroidal rupture: A history of eye trauma can cause CNV, especially if there's a rupture of the choroid.
- Do Not Miss Diagnoses
- Central serous chorioretinopathy (CSC): Although typically presenting with serous detachment, CSC can sometimes mimic CNV and is crucial to differentiate due to its different management.
- Ocular tumors (e.g., choroidal melanoma): Although rare, these can mimic CNV and have a significantly different prognosis and treatment.
- Inflammatory conditions (e.g., multifocal choroiditis, punctate inner choroidopathy): These can cause CNV and have a different treatment approach, often involving immunosuppression.
- Rare Diagnoses
- Sarcoidosis: A systemic granulomatous disease that can rarely cause CNV.
- Presumed ocular histoplasmosis syndrome without a history of histoplasmosis exposure: This can present similarly to other causes of CNV but may have a different geographic distribution.
- Choroidal osteoma: A rare, benign tumor of the choroid that can cause CNV.
- Pseudoxanthoma elasticum (PXE): A genetic disorder that affects the elastic fibers in some tissues, including the eye, leading to angioid streaks and potential CNV.