PMC4357687_01
a, b Color fundus picture of the OD (a) and OS (b) showing peripapillary exudates (arrowheads) and epipapillary vessel dilations (arrow) in December 2010. c, d Fluorescein angiogram depicting the disc staining in the OD (c) and OS (d). e, f OCT showing the near-normal right macula (e) and subretinal fluid with hyperreflective dots corresponding to hard exudates in the OS (f).
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F1
Both optic discs were hyperemic with dilated epipapillary arterioles in association with peripapillary exudates especially prominent in the OS (fig. 1a, b). Fluorescein angiography exhibited marked bilateral disc staining (fig. 1c, d). While the right optic coherence tomography (OCT) analysis was near-normal (fig. 1e), there was subfoveal serous detachment with multiple hyperreflective dots corresponding to hard exudates in the OS (fig. 1f).
a, b Color fundus picture of the OD (a) and OS (b) showing the persistent peripapillary exudates (arrowheads) with peripheral vasculitis (arrows) in April 2013, at the time when the diagnosis of IRVAN syndrome was established. c, d Fluorescein angiogram depicting 360  severe peripheral capillary nonperfusion bilaterally in the OD (c) and OS (d). OCT revealing near-normal macula in the OD (e) and subretinal fluid with hyperreflective dots corresponding to hard exudates in the OS (f).
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F2
April 2013, almost 3 years after the last intravitreal injection. At this visit, the visual acuity was unchanged OU, but there were 360  peripheral vasculitic changes and marked peripapillary exudates OU (fig. 2a, b). The fluorescein angiogram depicted severe 360  peripheral capillary nonperfusion bilaterally (fig. 2c, d). On OCT examination, while the right macula looked still near-normal (fig. 2e), there was serous retinal detachment at the papillomacular area and multiple hyperreflective dots corresponding to hard exudates in the OS (fig. 2f).
a, b Color fundus picture of the OD (a) and OS (b) at the last visit in November 2014 depicting the resolution of peripapillary exudates with a stable fundus appearance. OCT exhibiting a flat posterior pole in the OD (c) and OS (d).
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F3
Marked resolution of the peripapillary exudates was shown OU (fig. 3).