PMC8116590_01
(A) A fundus photograph of the right eye showing thick, white confluent sheathing around retinal veins suggestive of frosted branch angiitis, disc hyperemia, and macular edema. (B) A fundus photograph of the left eye showing normal appearance. (C) Recurrent skin rash on both thighs. (D) Optical coherence tomography of the right eye showing exudative macular detachment, vitreous cells, and posterior vitreous detachment. (E) Old lacunar infarction involving the right basal ganglia and the lateral ventricle (red arrow) in magnetic resonance (MR) T2 phase, but not in the diffusion-weighted imaging (DWI) (image not showed). (F) Fresh lacunar infarction in the right pons (red arrow) in MR DWI. (G,H) Fluorescein angiography of the right eye showing extensive vascular leakage and supratemporal capillary non-perfusion areas.
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F1
Moreover, macular edema and disc hyperemia were presented (Figure 1A). Fundus photograph of the left eye showed normal appearance (Figure 1B). Optical coherence tomography (OCT) suggested macular edema (Figure 1D). Fluorescein angiography (FA) revealed supratemporal bleeding-blocked fluorescence, concomitant capillary non-perfusion zone, and extensive dye leakage from vessels and the optic disc (Figures 1G,H). The patient has a history of intermittent and recurrent fever, skin rash (Figure 1C), and aphthous ulcer from 5 years ago. Magnetic resonance imaging (MRI) revealed lacunar infarction in the right basal ganglia and the lateral ventricle (Figure 1E). MRI confirmed fresh lacunar infarction in the right pons (Figure 1F).
(A-C) Ultra-wide-angle fundus photographs of the right eye from 1, 2, and 5 months post-treatment. White sheathing of the vessels alleviated first, and supratemporal hemorrhage resolved at 5 months later. (D) Optical coherence tomography of the right eye 1 month after treatment showing disappearance of subretinal exudation and much less vitreous cells.
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F2
One month later, the macular edema was resolved in the right eye (Figure 2D). White sheathing of the vessels alleviated (Figure 2A). Two months later, a fundus photo showed full resolution of vascular sheathing (Figure 2B) and visual acuity improved to 20/133. Retinal hemorrhage was absorbed at 5 months follow-up (Figure 2C).
Time-line of main events of the patient.
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F3
The brief timeline of our case is described in Figure 3.