OSLI Retina

September 2020

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September 2020 ยท Vol. 51, No. 9 531 antineutrophil cytoplasmic antibodies (ANCA), QuantiFERON gold, and rapid plasma reagin (RPR), and fluorescent treponemal antibody (FTA) was nega- tive. Observation was recommended. At the last fol- low-up 6 months later, the patient was asymptomatic, VA remained 20/20 OS, and the lesion was regressed (Figures 1G-1J). Case 2 A 36-year-old woman presented with photopsia OS for 2 weeks. At the onset of visual symptoms, she de- veloped a flu-like illness associated with fevers for 24 hours and lesions on her palms, which resolved prior to presentation. Just prior to the development of these visual and systemic findings, her 18-month-old daugh- ter was diagnosed with hand, foot, and mouth disease. VA was 20/20 OU. Anterior segment examination and IOPs were normal OU. Funduscopic examination OD was normal. Examination OS was significant for three well-circumscribed hypopigmented outer retinal le- sions in the nasal midperiphery (Figure 2A). OCT of the macula was normal (Figure 2E). OCT through the Figure 2. A 36-year-old woman with cox- sackie retinopathy. (a) Color fundus photog- raphy illustrates three well-circumscribed hypopigmented outer retinal lesions in the nasal midperiphery of the left eye. Fundus autofluorescence (b) shows patchy hyperau- tofluorescence resembling a bull's-eye corre- sponding to the site of the lesions nasal to the optic disc. Fluorescein angiography (c) shows three areas of window defect corresponding to the outer retinal lesions, whereas indo- cyanine green angiography (d) is unremark- able. Although optical coherence tomography (OCT) through the macula (e) is unreveal- ing, OCT nasal to the disc (f) displays outer retinal lesions with disruption of the ellipsoid zone band and the retinal pigment epithelium (RPE). Upon follow-up 5 weeks later, fundus photograph (g), fundus autofluorescence (h), OCT through the macula (i), and OCT through the lesions (j) illustrate partial regression of the lesions.

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