Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
Retin Cases Brief Rep. 2022 May 1;16(3):347-350. doi: 10.1097/ICB.0000000000000978. Epub 2020 Feb 6.
To report an unusual case of early macular necrosis in acute retinal necrosis and its features on multimodal imaging.
Findings on fundus examination, laboratory workup, fluorescein angiography, autofluorescence, optical coherence tomography, and optical coherence tomography angiography.
A 31-year-old healthy woman presented with 1 week of photophobia and central scotoma of the right eye. Initial examination revealed vitritis, hyperemia of the optic disc, and a yellow-white macular lesion without any peripheral findings. Peripheral involvement was first noted only 4 days later. The patient was diagnosed with acute retinal necrosis secondary to varicella zoster virus and was successfully treated with intravitreal and oral antiviral medications. Optical coherence tomography imaging of the macular lesion showed involvement of both the inner and outer retina. Optical coherence tomography angiography revealed a large flow void in the choriocapillaris, which has not been previously demonstrated.
Multimodal imaging offers valuable information in the evaluation of patients with acute retinal necrosis.
报告急性视网膜坏死中早期黄斑坏死的一例罕见病例及其在多模态成像上的特征。
眼底检查、实验室检查、荧光素血管造影、自发荧光、光学相干断层扫描和光学相干断层扫描血管造影的结果。
一名 31 岁健康女性因右眼畏光和中心暗点就诊，病程为 1 周。最初的检查发现玻璃体炎症、视盘充血和黄斑处黄色白色病灶，但无任何周边发现。仅在 4 天后才首次发现周边受累。该患者被诊断为带状疱疹病毒引起的急性视网膜坏死，并通过玻璃体内和口服抗病毒药物成功治疗。黄斑病变的光学相干断层扫描成像显示内外层视网膜均受累。光学相干断层扫描血管造影显示脉络膜毛细血管中存在大的血流空影，这在以前尚未被证明过。
多模态成像为评估急性视网膜坏死患者提供了有价值的信息。
