PMC5602126_01
Optic disc edema in both eyes and a choroid lesion between the disc and fovea in the right eye.
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F1
Funduscopic examination revealed bilateral swelling of the optic discs, a grayish-white mass in the superotemporal peripapillary region between the disc and fovea, and hard exudates around the fovea in the right eye (Fig. 1).
Fluorescein angiography shows optic disc staining in both eyes.
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F2
Fluorescein angiography (FA) revealed optic disc staining in both eyes (Fig. 2).
Automated static perimetry reveals a substantially enlarged blind spot in the right eye.
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F3
Automated static perimetry revealed a substantially enlarged blind spot of the right eye, which was compatible with the clinical symptom and fundus examination (Fig. 3).
Chest computed tomography reveals multiple enlarged nodes in multiple compartments of the bilateral mediastinum and the bilateral hilar region (red arrows).
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F4
The differential diagnosis included lymphoma (Fig. 4).
(A) Granuloma tissue without caseous necrosis. (B) Cytokeratin staining is negative, which excludes a malignant tumor.
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F5
Therefore, a diagnosis of lymphoma was excluded (Fig. 5).
After corticosteroid treatment, the volume of the peripapillary lesion decreased.
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F6
After retrobulbar injection of triamcinolone 1.5 mL (10 mg/mL) into the right eye and systemic treatment with oral prednisolone (15 mg 3 times daily; total, 45 mg/d) for 3 months, the patient's optic disc and macular lesions improved (Figs. 6 and 7).
After corticosteroid treatment, fluorescein angiography shows that bilateral optic disc staining resolved.
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F7
After retrobulbar injection of triamcinolone 1.5 mL (10 mg/mL) into the right eye and systemic treatment with oral prednisolone (15 mg 3 times daily; total, 45 mg/d) for 3 months, the patient's optic disc and macular lesions improved (Figs. 6 and 7).
After corticosteroid treatment, the visual field defect resolved.
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F8
Approximately 1 month later, the VF defect resolved (Fig. 8).