PMC4821144_01
a Color fundus photo mosaic. A superior hemivein occlusion, with frosted branch angiitis and neuroretinitis. Retinal hemorrhages inferior to the optic disc. b-d Fluorescein angiogram. b OD transit phase (25 s): late filing of the superior veins, accompanied by hypofluorescent foci due to blockage by retinal hemorrhages. c OD (5 min): hot disc, hyperfluorescent superior vein walls and capillary nonperfusion areas. No macular leakage was seen throughout the various angiographic stages. d OS (5 min): hot disc with no additional findings. e, f OCT. e OD. Hyperreflective foci in the vitreous corresponding to vitreal cells, an elevated foveal contour with subfoveal fluid, and hyperreflective foci mostly in the outer plexiform layer, corresponding to the star-shaped exudates seen clinically. f OS. Vitreal cells and hyperreflective foci in the outer plexiform layer corresponding to star-shaped exudates.
cop-0007-0141-g01.jpg
PMC4821144_01_cop-0007-0141-g01.jpg
F1
Retinal hemorrhages were also seen inferior to the optic disc (fig. 1a). Fluorescein angiography of the right eye demonstrated a superior hemivein occlusion with occlusive vasculitis (fig. 1b-d). Both eyes demonstrated different stages of neuroretinitis (fig. 1e, f).
a Color fundus image. Normal optic disc, remnants of retinal hemorrhages, and sclerosis of superior temporal vein. Prominent star-shaped exudates. b OCT image. Remnants of subretinal fluid and hyperreflective foci in the outer plexiform layer corresponding to star-shaped exudates.
cop-0007-0141-g02.jpg
PMC4821144_01_cop-0007-0141-g02.jpg
F2
OD, color vision significantly improved to 11/12, with significant clinical improvement (fig. 2a). OCT showed absorption of most of the subretinal fluid (fig. 2b).
a Fundus image OS. Blurring of disc margins, a gray lesion on the disc, and macular elevation. b OCT OS. Vitreal cells, retinal and subretinal fluid and an optic disc lesion. c Resolution of fluid and the optic disc lesion following prednisone re-initiation.
cop-0007-0141-g03.jpg
PMC4821144_01_cop-0007-0141-g03.jpg
F3
The macula was elevated (fig. 3a). OCT demonstrated recurrence of neuroretinitis (fig. 3b). A week later, substantial improvement was seen: BCVA improved to 20/25, and the macular edema and optic nerve lesion resolved (fig. 3c).