PMC5892311_01
Fundus photos of the initial visit of the right eye (a) and left eye (d). Fundus autofluorescence of the initial visit of the right eye (b) and left eye (e) showed absence of the normal foveal hypoautofluorescence. Late-phase fluorescein angiography of the initial visit of the right eye (c) and left eye (f) showed diffuse leakage.
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F1
Eye exams were significant for a blunt foveal reflex with parafoveal retinal opacification and fine yellow intraretinal nonrefractile deposits (Fig. 1a, d). Fundus autofluorescence showed absence of the normal foveal hypoautofluorescence (Fig. 1b, e). FA revealed diffuse deep perifoveal late leakage in both eyes (Fig. 1c, f).
Horizontal sections of optical coherence tomography on the initial visit showed a large foveal cyst in the right eye (a) and a defect of the cone outer segment and ellipsoid zone in the left eye (c). Horizontal section of optical coherence tomography on follow-up showed a decrease in the size of cavitation due to "collapse" of the roof in the right eye (b) and partial resolution of the initial defects in the ellipsoid zone and outer segments of the photoreceptors of the left eye (d).
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F2
Spectral domain high-definition (HD) OCT of the right eye revealed a large outer foveal cyst with disrupted retinal pigment epithelium and outer retinal bands, and thinning of the foveal layers (Fig. 2a). In the left eye, OCT examination showed a defect in the cone outer segments and ellipsoid zone of the fovea (Fig. 2c). Macular HD OCT showed a decrease in the size of the foveal cavitation in the right eye (Fig. 2b) and partial resolution of the defects of the ellipsoid zone and the cone outer segments of the left eye (Fig. 2d).
Optical coherence tomography angiogram showed vascular remodeling and capillary plexus thinning in the inner retinal layers (right eye, a; left eye, d) and middle retinal layers (right eye, b; left eye, e) temporal to the fovea. Retinal vessels are noted in the normally avascular outer retina (right eye, c; left eye, f).
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F3
Angioplex OCTA on the most recent office visit of the fovea in both eyes revealed thinning of the capillary plexus with a coarse branching pattern in the inner and middle retinal layers (Fig. 3a, b, d, e), with vascular invasion of the normally avascular outer retinal layers (Fig. 3c, f), more prominent in the right eye.