case_images: PMC6201244_01
case_images: Multimodal Imaging of the Retina Prior to Plasma Exchange A and B, Color fundus montage of the right (A) and left (B) eye showing showing multiple nevi, orange polygonal pigment and round reddish lesions. C and D: fundus autofluorescence (30  Heidelberg Retinal Angiograph; Heidelberg Engineering) demonstrating increased autofluorescence corresponding to the polygonal pigment and absence of autofluorescence corresponding to the round areas of presumed RPE atrophy. E and F: near infrared images showing the dark round lesions corresponding to presumed RPE atrophy and a bright lesion in the right eye corresponding to a choroidal nevus. G and H: spectral domain (OCT) demonstrated macular neurosensory detachment with focal areas of RPE atrophy and hypertrophy, and a highly reflective choroidal nevus in the right eye; enhanced depth imaging optical coherence tomography (EDIOCT) demonstrated thickened choroid in both eyes.
case_images: nihms-989181-f0001.jpg
case_images: PMC6201244_01_nihms-989181-f0001.jpg
case_images: F1
case_images: Color fundus photography revealed multiple pigmented nevi OU and round reddish islands of retinal pigment epithelium (RPE) separated by a pattern of polygonal orange pigmentation (Figures 1A and1B). Fundus autofluorescence (30  Heidelberg Retinal Angiograph; Heidelberg Engineering) demonstrated increased levels of autofluorescence corresponding to the orange polygonal lesions and decreased levels of expected RPE autofluorescence, corresponding to the round areas of presumed RPE atrophy (Figures 1C and1D). These round lesions appeared dark on the near infrared images (Figures 1E and1F). Spectral domain optical coherence tomography (OCT) demonstrated macular neurosensory detachment with focal areas of RPE atrophy and hypertrophy OU (Figures 1G and1H). In addition to the highly reflective choroidal nevi, thickened choroid OU was noted on the enhanced depth imaging OCT (EDI-OCT) (Figures 1G and1H).
case_images: Multimodal imaging of the retina after plasma exchange A and B, Color fundus of the right (A) and left (B) eye showing showing enlarged multiple nevi, contracted orange polygonal pigment and increased pigment clumping. C and D: fundus autofluorescence (30  Heidelberg Retinal Angiograph; Heidelberg Engineering) demonstrating increased autofluorescence corresponding to the polygonal pigment and increased absence of autofluorescence corresponding to presumed RPE atrophy. E and F: near infrared images showing loss of the dark round lesions and enlarged bright lesion in the right eye corresponding to a choroidal nevus. G and H: spectral domain (OCT) demonstrated resolved macular neurosensory detachment with focal areas of RPE atrophy and hypertrophy, and an enlarged choroidal nevus in the right eye; enhanced depth imaging optical coherence tomography (EDIOCT) demonstrated stable thickened choroid in both eyes.
case_images: nihms-989181-f0002.jpg
case_images: PMC6201244_01_nihms-989181-f0002.jpg
case_images: F2
case_images: Multimodal imaging demonstrated the progression of RPE atrophy (Figures 2A and2B), nevi growth (Figures 2C and2D), resolution of neurosensory detachments (Figures 2E and2F) and stable choroidal thickening on EDI-OCT (Figures 2G and2H).