PMC9149465_01
Color fundus photographs, FA and macular optical coherence tomography (OCT) at presentation (a-c, RE; g-i, LE) and follow-up visits (d-f, RE; j-l, LE). a At presentation, color fundus photograph of the RE showed tortuous vessels and diffuse intraretinal lipid. b Corresponding FA showed diffuse leakage in the macula. c OCT showed atrophy involving the fovea. d-f At 1-month follow-up, repeat images were largely stable in the RE. g At presentation, color fundus photograph of the LE showed vascular tortuosity, scattered intraretinal hemorrhages, and Elschnig spots. h Corresponding FA showed diffuse leakage. i OCT showed a serous macular detachment, hyper-reflective material in the subretinal space, and a central subfield thickness measuring 1,285 microns. At 1-month follow-up, repeat images show decreased intraretinal hemorrhages (j), resolution of vascular leakage (k) and decreased subretinal fluid (l).
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F1
RE Snellen best corrected visual acuity (BCVA) was 20/200 (baseline), examination revealed diffuse intraretinal lipid, ultrawide-field fluorescein angiography (FA) showed diffuse leakage in the macula, and spectral domain optical coherence tomography showed chronic atrophic changes in the central macula (Fig. 1a-c). In addition, a relative afferent pupillary defect, vascular tortuosity, intraretinal hemorrhages, and Elschnig spots were observed (Fig. 1g). Ultrawide-field FA showed an enlarged foveal avascular zone, capillary dropout, and multifocal leakage (Fig. 1h). Spectral domain optical coherence tomography in the LE showed serous macular detachment with a central subfield thickness of 1,285 microns (Fig. 1i). In addition, subretinal fluid in the macula improved dramatically (Fig. 1 j-l) and resolved by month three.
3 x 3 mm OCTA of the LE. Diffuse patchy choriocapillaris flow loss was observed at week 1 (a) that improved significantly by month 3 (b). Corresponding images of neuroretina were shown and demonstrated diffuse loss of flow at week 1 (c) that remained relatively unchanged at month 3 (d).
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F2
At the 1-week follow-up visit, BCVA improved from 20/400 to 20/80, but OCTA showed extensive flow loss in both the choriocapillaris (Fig. 2a) and neuroretina (Fig. 2c). BCVA in the LE further recovered to 20/40 with significant improvement in the choriocapillaris perfusion (Fig. 2b), and stable flow deficits in the neuroretina (Fig. 2d). BP reading at the 3-month follow-up was 146/80.