PMC10293943_01
Baseline findings. a An ultra-widefield fundus photograph taken with Optos California (Nikon Corporation, Tokyo, Japan). Multiple retinal hemorrhages are observed throughout the fundus, and retinal veins are tortuous and dilated. b Vertical section of optical coherence tomography (OCT) image taken with Cirrus HD-OCT (Carl Zeiss Meditec, Dublin, CA, USA). Cystoid macular edema and small serous retinal detachment (arrow) are observed. c, d Ultra-widefield fluorescein angiograms taken with Optos California (c early phase, d late phase). Multiple hypofluorescent spots that appeared to be fluorescent block due to retinal hemorrhages (c, d) and hyperfluorescent leakage from the retinal veins are observed (d).
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F1
Slit lamp examination revealed no abnormalities in the anterior segments and clear ocular media, but the fundus examination showed retinal hemorrhages throughout the fundus, dilated and tortuous retinal veins, and macular edema (Fig. 1a, b). Optical coherence tomography (OCT) showed cystoid macular edema and small serous retinal detachment (Fig. 1b). Fluorescein angiograms showed multiple hypofluorescent spots that appeared to be fluorescent block due to retinal hemorrhages and hyperfluorescent leakage from the retinal veins (Fig. 1c, d).
Baseline findings. a A diffusion-weighted image of brain magnetic resonance imaging. No abnormal findings such as cerebral infarction are seen. b Head magnetic resonance angiography scan. No abnormal findings such as cerebral aneurysm are seen.
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F2
Magnetic resonance (MR) imaging of the brain showed no evidence of cerebral infarction and head MR angiography showed no abnormal findings such as cerebral aneurysm (Fig. 2a, b).
Findings 10 months after the onset. a An ultra-widefield fundus photograph taken with Optos California (Nikon Corporation, Tokyo, Japan). Retinal hemorrhages almost resolved. b Vertical section of optical coherence tomography (OCT) image taken with Cirrus HD-OCT (Carl Zeiss Meditec, Dublin, CA, USA). Cystoid macular edema and serous retinal detachment disappear.
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F3
Five IVAs were performed over a 10-month follow-up period, with resolution of macular edema and retinal hemorrhages (Fig. 3a, b), and the BCVA recovered to 20/20.