OSLI Retina

September 2020

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530 Ophthalmic Surgery, Lasers & Imaging Retina | Healio.com/OSLIRetina normal in both eyes (OU). Fundus examination was normal OD. Examination OS was significant for a yel- low outer retinal lesion superonasal to the optic disc (Figure 1A). Optical coherence tomography (OCT) of the macula was normal (Figure 1C). OCT through the lesion displayed disruption of the ellipsoid zone and thickening and hyperreflectivity at the level of the RPE (Figure 1D). Fundus autofluorescence (FAF) il- lustrated hyperautofluorescence in the center of the lesion with surrounding hypoautofluorescence (Fig- ure 1B). Fluorescein angiography (FA) was remark- able for leakage at the site of the outer retinal lesion (Figure 1E), whereas indocyanine green angiography (ICG) was unremarkable (Figure 1F). Coxsackie titers drawn at this time were positive (Coxsackie A4 titer > 1:64, Coxsackie B4 titer 1:80). The remainder of the infectious and inflammatory work-up including po- liovirus titers, Lyme disease antibodies, Bartonella henselae antibodies, Zika virus titers, Chikungunya virus titers, angiotensin converting enzyme (ACE), Figure 1. A 42-year-old man with cox- sackie retinopathy. (a) Color fundus pho- tography illustrates a hypopigmented outer retinal lesion at the superonasal disc margin in the left eye. Fundus au- tofluorescence (b) shows hyperautofluo- rescence. Although optical coherence tomography (OCT) through the macula (c) is unrevealing, OCT superonasal to the optic disc (d) displays an outer reti- nal lesion with disruption of the ellipsoid zone band and the retinal pigment epi- thelium (RPE). Fluorescein angiography (e) shows hyperfluorescence and mini- mal leakage corresponding to the site of the lesion superonasal to the optic disc while indocyanine green angiography (f) is normal. Upon most recent follow-up 6 months after initial presentation, fun- dus photograph (g), fundus autofluores- cence (h), OCT through the macula (i), and OCT through the lesion (j) illustrate partial regression of the lesion.

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