PMC8205573_01
Fundus photography of the right (a) and left (b) eyes showing pale, edematous optic discs, cotton wool patches, and intraretinal hemorrhages.
CRIOPM2021-9952500.001.jpg
PMC8205573_01_CRIOPM2021-9952500.001.jpg
fig1
Fundus examination (Figure 1) revealed bilateral swollen, pale optic discs, with peripapillary cotton wool spots, intraretinal hemorrhages in the right fundus (Figure 1(a)), and retinal nerve fiber layer hemorrhages in the left fundus (splinter hemorrhages, Figure 1(b)).
30-2 (a) and central 10-2 (b) visual field plots of both eyes of the patient showing tubular fields with small, central remnant islands of vision.
CRIOPM2021-9952500.002.jpg
PMC8205573_01_CRIOPM2021-9952500.002.jpg
fig2
Visual field examination was ordered (Figure 2) and revealed severe constriction in the fields of both eyes (tubular fields) on the 30-2 exams (Figure 2(a)). Central 10 degrees examination (Figure 2(b)) confirmed the presence of small remnant islands in the central fields of both eyes.
OCT of the right (a) and left (b) maculae showing preserved foveal architecture but distorted and thickened peripapillary nerve fiber layer, more pronounced in the right eye.
CRIOPM2021-9952500.003.jpg
PMC8205573_01_CRIOPM2021-9952500.003.jpg
fig3
Optical coherence tomography (OCT) of the macula (Figure 3) revealed preserved foveal anatomy, with thickening and distortion of the peripapillary retinal nerve fiver layer which, in the right eye, was more pronounced and associated with intraretinal edema.
OCT-A of the right and left eyes showing peripapillary distortion of the retinal nerve fiber layer and pronounced loss of the capillary microvascular perfusion.
CRIOPM2021-9952500.004.jpg
PMC8205573_01_CRIOPM2021-9952500.004.jpg
fig4
OCT-Angiography (OCT-A) of the optic disc (Figure 4) showed diffuse distortion and loss of the peripapillary microvascular cuff in both eyes.