PMC5465648_01
Fundus photography (a, b) and fluorescein angiography (c, d) images of the right (a, c) and the left (b, d) eye. There is a blurrily visible macular area due to lens opacity on the right eye (a). Marked tortuosity of the second- and third-order retinal arterioles is present in the macula and peripapillary area, as well as multiple retinal hemorrhages in the perifoveal area of the right (a) and the left (b) eye. Fluorescein angiography of the right (c) and the left (d) eye showed tortuous arterioles without leaking and blocked fluorescence due to retinal hemorrhage.
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Findings from fluorescein angiography showed arteriolar tortuosity and blocked fluorescence from retinal hemorrhage, but vascular filling defects or hyperfluorescent lesions were absent (Fig. 1).
Brain magnetic resonance images of the patient. a Marked multiple chronic ischemic lesions in the periventricular white matter (white arrows) and subcortical deep white matter (black arrows) on T2-weighted imaging. b Small, restricted diffusion in the left hippocampus (white arrow) on diffusion-weighted imaging.
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She underwent magnetic resonance imaging (MRI) including angiography of the brain at the time of the clinical symptoms and demonstrated multiple chronic ischemic lesions in the periventricular and subcortical white matter, as well as a small infarction in the hippocampus (Fig. 2).
Fundus photographs of the eyes of the daughter (a) and the son (b). a There is a blot hemorrhage (white arrowhead) on the right eye and mild arteriolar tortuosity (black arrows) on the left eye of the daughter. b Marked tortuous arterioles without hemorrhage.
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Her 26-year-old daughter and 24-year-old son had tortuous arterioles at the vascular arcade without hemorrhage (Fig. 3).