PMC8476279_01
Fundus photo OD with no evidence of pathology (a). Fundus photo OS with mild retinal venous dilatation and tortuosity with scattered blot hemorrhages (b). Fundus autofluorescence does not reveal hyperfluorescent lesions or RPE changes (c, d) apart from the masking effect from blot hemorrhages OS (d). Optical coherence tomography-angiography demonstrates a focal, small area of capillary dropout in the deep capillary plexus (f). Superficial capillary plexus, outer retina, and choriocapillaris appear normal (e, g, h). Fundus photo OS, 1 month after presentation with fewer blot hemorrhages (i). Fundus photo after 6 months of OS shows complete resolution of the hemorrhages (j).
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fig1
Fundoscopy OS revealed mild retinal venous dilatation and tortuosity with scattered blot hemorrhages (Figures 1(a) and 1(b)). Extensive multimodal imaging which included OCT, fundus autofluorescence (FAF), optical coherence tomography-angiography (OCT-A), and fluorescein angiography (FA) was performed (Figures 1(c)-1(h)). OPL and partial resolution of the hyperreflective lesions (Figure 2(c)). OCT-A remained unaltered (Figure 1(i)). Fundoscopy revealed complete resolution of the hemorrhages and the whitish lesions (Figure 1(j)).
Swept-source- (SS-) OCT imaging of the left eye. Horizontal scans are presented on the left column and vertical ones on the right one (lines 1 and 6 on DRI OCT Triton, SS-OCT, respectively). OCT scans on presentation demonstrated diffuse, hyperreflective lesions at the level of the inner plexiform layer, inner nuclear layer, and outer plexiform layer (a, b). Partial resolution (one month later) (c, d) and complete resolution (six months later) (e, f) of the lesions are observed along with thinning of the inner retina.
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fig2
Figures 2(a) and 2(b)). Fundus autofluorescence did not reveal any hyper- or hypofluorescent lesions of the Retinal Pigment Epithelium (RPE). OPL and partial resolution of the hyperreflective lesions (Figure 2(c)). OCT-A remained unaltered (Figure 1(i)). OCT showed INL and OPL thinning and complete resolution of the hyperreflective lesions (Figure 2(d)).
Fluorescein angiography (FA) images OS shows a masking effect due to blot hemorrhages and early punctuate leakage in the upper retina: (b) 1.09 min, (c) 1.19 min, (d) 1.29 min, (e) 1.38 min, and (f) 4.30 min.
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fig3
Fluorescein angiography revealed normal arteriovenous transit time, masking effect due to blot hemorrhages, and early punctuate leakage in the inner retina (Figure 3).