A 35-year-old man presented with sudden central vision loss in his left eye.
His personal history included a common cold 10 days prior to the episode.
Clinical examination revealed a visual acuity without correction (BCVA) of 0.9 in the right eye and 0.1 in the left eye, with metamorphopsia in the left eye.
No inflammatory signs or anomalies were observed in the anterior segment.
The left eye fundus showed macular thickening of approximately 2 papillary diameters (PD) with small intraretinal hemorrhages.
The fundus of the right eye showed a white-yellowish lesion with a papilla diameter, temporal lower than the macula.
Complementary examinations included fluorescein angiography (FFA) and indocyanine green angiography (IVA), optical coherence tomography (OCT), B-mode ultrasound, and complete blood analysis.
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In the FFA of the left eye, a patchy hypofluorescence pattern appears at very early times, followed by diffuse hyperfluorescence of the posterior pole with a hyperfluorescent area of 1 better delimited SD and of subfoveal location.
In the LVA, a hypofluorescent zone with poorly defined borders is observed in the posterior pole, which is maintained with angiographic times.
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OCT shows a loss of foveal thickness due to the existence of a subfoveal intraretinal cyst accompanied by small areas of perifoveal neurosensory retinal detachment (NSRD).
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Both ultrasound and analytical study do not provide relevant findings.
This bilateral yellowish-white lesion, although asymmetric, of inflammatory origin and location in the chorioretinal interface established as a probable diagnosis an acute posterior placoid epitheliopathy of presentation a.
Due to the great loss of VA, treatment with systemic oral corticosteroids was initiated with prednisone 1mg/kg. A daily prescription tablet was also administered.
At 2 weeks, the patient came to follow-up referring a very slight improvement in his left eye.
The AUC is 0.9 and 0.15, respectively.
At the bottom of the eye, an increase in the pigmentation of the lesions began to be seen without any other sign of interest.
The OCT showed subfoveal PRS alteration in the left eye, not identifying the previously described small perifoveal NRDs.
This is when the corticosteroid regimen began to be reduced.
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After 5 weeks, the patient showed a significant improvement with a BCVA of 0.9 in the RE and 0.6 in the LE.
Figure 5A shows the healing of the lesions, which was corroborated by a control FFA.
In the last control performed one year after the onset of the episode, the patient had a complete recovery of visual acuity of 0.9 in both eyes without correction.
In the eye fundus we found hyperpigmentation of the lesions corresponding to the healing of the same.
