Kahloun Rim, Jelliti Bechir, Ksiaa Imen, Ben Amor Hager, Zaouali Sonia, Lupidi Marco, Ben Yahia Salim, Khairallah Moncef
Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia.
Department of Biochemical and Surgical Sciences, Section of Ophthalmology, University of Perugia, Perugia, Italy.
Retin Cases Brief Rep. 2019 Fall;13(4):348-351. doi: 10.1097/ICB.0000000000000603.
To report optical coherence tomography angiography findings in a patient with rickettsial retinitis.
A 29-year-old man complaining of acute blurring vision in the right eye associated with Rickettsia conorii infection underwent a comprehensive ocular examination, fluorescein angiography, spectral-domain optical coherence tomography, and swept-source optical coherence tomography angiography.
Funduscopy showed two large areas of retinitis in the inferior macula along the distribution of the inferotemporal artery with associated retinal hemorrhages, retinal edema, and serous retinal detachment. Fluorescein angiography showed early hypofluorescence and late staining of white retinal lesions and associated adjacent retinal vascular leakage and optic disc hyperfluorescence. Optical coherence tomography angiography showed hypointense dark areas in the superficial capillary plexus and larger hypointense areas in the deep capillary plexus, outer retina, and choriocapillaris layer. The patient was treated with doxycycline and prednisone. Six weeks after presentation, retinal changes seen at the acute phase had resolved, leading to mild residual retinal pigment epithelial changes. Fluorescein angiography showed retinal capillary nonperfusion within areas of resolved retinitis. Spectral-domain optical coherence tomography findings included inner retinal atrophy, intraretinal cysts, and disruption of ellipsoid zone and interdigitation zone. Swept-source optical coherence tomography angiography showed well-delineated hypointense greyish areas of retinal capillary nonperfusion in both the superficial and deep capillary plexuses. Visual field testing revealed the presence of a corresponding paracentral defect.
Optical coherence tomography angiography may be a valuable noninvasive imaging technique for detecting and analyzing occlusive complications associated with rickettsial retinitis.
报告一例立克次体性视网膜炎患者的光学相干断层扫描血管造影结果。
一名29岁男性，因感染康氏立克次体后出现右眼急性视力模糊，接受了全面的眼部检查、荧光素血管造影、光谱域光学相干断层扫描和扫频光学相干断层扫描血管造影。
眼底检查显示，沿颞下动脉分布的黄斑下有两个大片状视网膜炎区域，伴有视网膜出血、视网膜水肿和浆液性视网膜脱离。荧光素血管造影显示白色视网膜病变早期低荧光、晚期染色，以及相关的相邻视网膜血管渗漏和视盘高荧光。光学相干断层扫描血管造影显示浅表毛细血管丛中有低信号暗区，深层毛细血管丛、外层视网膜和脉络膜毛细血管层中有更大的低信号区。患者接受了强力霉素和泼尼松治疗。就诊六周后，急性期所见的视网膜病变已消退，导致轻度的视网膜色素上皮残留改变。荧光素血管造影显示消退的视网膜炎区域内视网膜毛细血管无灌注。光谱域光学相干断层扫描结果包括视网膜内层萎缩、视网膜内囊肿以及椭圆体带和指状交叉带中断。扫频光学相干断层扫描血管造影显示浅表和深层毛细血管丛中均有界限清晰的视网膜毛细血管无灌注低信号灰色区域。视野检查发现相应的旁中心缺损。
光学相干断层扫描血管造影可能是一种有价值的非侵入性成像技术，用于检测和分析与立克次体性视网膜炎相关的闭塞性并发症。
