Beijing Tongren Hospital, Capital Medical University, Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, 00730, China.
Hengshui People's Hospital (Harrison International Peace Hospital), Hebei, 053000, China.
BMC Ophthalmol. 2024 Nov 14;24(1):498. doi: 10.1186/s12886-024-03757-3.
This study aimed to present a case of bilateral symmetric onset of acute idiopathic maculopathy after high fever with peripheral vascular occlusion.
A 54-year-old yellow female experienced acute binocular visual acuity decrease after 1 day of high fever, and binocular visual acuity decreased to index or anterior. OCT in the external hospital showed dome-shaped cortical detachment in the symmetrical macular area of both eyes with subretinal fluid, discontinuity in the ellipsoid zone and the chimera. The patient autonomously administered antibiotics and non-steroidal anti-inflammatory agents, including amoxicillin and ibuprofen. Following a three-day period, the patient's visual acuity demonstrated significant improvement. Additionally, macular edema demonstrated a notable reduction as indicated by optical coherence tomography, while the presence of peripheral retinal vascular occlusions was also observed on fluorescein fundus angiography. At the onset of 6 days, oral hormone therapy was given in the outside hospital, with no significant improvement in visual acuity.23 days after the onset of the disease, the patient was admitted to our hospital, and was finally diagnosed as acute idiopathic maculopathy combined with the imaging findings of FFA, ICGA and OCT. During the follow-up, the visual acuity of both eyes improved spontaneously.
This case is a rare acute idiopathic macular lesion with bilateral involvement, accompanied by highly symmetrical peripheral retinal vascular occlusion in both eyes, which deepens our understanding of acute idiopathic maculopathy with a view to providing guidance for subsequent clinical practice.
本研究旨在报告一例高热伴外周血管阻塞后双侧对称起病的急性特发性黄斑病变。
一名 54 岁黄种女性，高热后 1 天出现双眼急性视力下降，双眼视力降至指数或眼前。外院 OCT 显示双眼对称黄斑区呈球形皮质脱离，伴视网膜下液，椭圆带和嵌合体连续性中断。患者自行使用抗生素和非甾体抗炎药，包括阿莫西林和布洛芬。3 天后，患者视力明显改善。此外，光学相干断层扫描显示黄斑水肿明显减轻，荧光素眼底血管造影显示周边视网膜血管阻塞。发病 6 天后，在外院给予口服激素治疗，视力无明显改善。发病 23 天后，患者入住我院，最终诊断为急性特发性黄斑病变，结合 FFA、ICGA 和 OCT 的影像学表现。随访过程中，双眼视力自发改善。
本例为罕见的双侧急性特发性黄斑病变，伴双眼高度对称的周边视网膜血管阻塞，加深了我们对急性特发性黄斑病变的认识，以期为后续临床实践提供指导。
