PMC3198414_01
Case 5. Fundus photo of the right eye shows a hyperemic disc with slightly indistinct borders especially nasally. The arteries are attenuated and the veins exhibit severe dilation and tortuosity with focal constrictions at areas of arterio-venous crossings. The posterior pole shows multiple intraretinal hemorrhages and cotton wool spots and retinal thickening. The perifoveal vessels are also dilated and tortuous and the foveal reflex is dull. There is a white-centered hemorrhage at the fovea.
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Other ophthalmic signs included central retinal vein thrombosis in Case 5 (Figure 1A and 1B), due to venous inflammation, focal choroiditis, multifocal choroiditis, focal keratopathy, anterior chamber cells, posterior synechiae, retinal hemorrhages, and papillitis.
Case 5. After treatment with sulfonamides and doxycycline, fundus photo shows that disc vessels are still dilated, but with distinct disc borders. There is marked decrease in vessel tortuosity and dilation. There is also an evident decrease in retinal edema and hemorrhages as compared to Figure 1A.
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One of them (Case 6) was cured, and the other one (Case 4) required a third treatment (Figure 2A to 2D) with 750 mg/12 hours for 10 days of oral ciprofloxacin.