case_images: PMC10912278_01
case_images: OCT images (G,H, arrows) of the hemorrhagic lesions shown in the color ophthalmoscopic (A,B), FAF (C,D), and NIR (E,F) images. OCT through the lesions revealed dense hyperreflective hemorrhages of the RNFL (G, white arrow) and sub-ILM (H, yellow arrow).
case_images: fmed-11-1322126-g002.jpg
case_images: PMC10912278_01_fmed-11-1322126-g002.jpg
case_images: fig2
case_images: Fundus examination revealed multilayered retinal hemorrhages in both eyes (Figures 1A,B, 2A,B, 3A-D), including preretinal hemorrhages and intraretinal hemorrhages. Fundus autofluorescence (FAF) images of both eyes revealed that the lesions were either hyper-FAF or hypo-FAF (Figures 1C,D, 2C,D, 3E-H), representing different periods of hemorrhages. Near-infrared reflectance (NIR) images showed well-defined retinal lesions (Figures 2E,F, 3I-L). Optical coherence tomography (OCT) helped to accurately locate the different layers of the lesions, including the retinal nerve fiber layer (RNFL) (Figure 2G), sub-inner limiting membrane (sub-ILM) (Figure 2H), outer plexiform layer (OPL) (Figure 3M), ellipsoid zone (EZ) (Figure 3N) and Henle fiber layer (HFL) (Figures 3O,P) hemorrhages.
case_images: OCT images (M-P) of the lesions shown in the color ophthalmoscopic (A-D), FAF (E-H) and NIR (I-L) images. OCT through the lesions revealed a hyperreflective band at the posterior border of the OPL (M, white arrows) and attenuation of the EZ (N, yellow arrows), representing hemorrhages of these outer retinal layers. OCT also showed EZ disruption and HFL hemorrhages (O,P, red arrows).
case_images: fmed-11-1322126-g003.jpg
case_images: PMC10912278_01_fmed-11-1322126-g003.jpg
case_images: fig3
case_images: Fundus examination revealed multilayered retinal hemorrhages in both eyes (Figures 1A,B, 2A,B, 3A-D), including preretinal hemorrhages and intraretinal hemorrhages. Fundus autofluorescence (FAF) images of both eyes revealed that the lesions were either hyper-FAF or hypo-FAF (Figures 1C,D, 2C,D, 3E-H), representing different periods of hemorrhages. Near-infrared reflectance (NIR) images showed well-defined retinal lesions (Figures 2E,F, 3I-L). Optical coherence tomography (OCT) helped to accurately locate the different layers of the lesions, including the retinal nerve fiber layer (RNFL) (Figure 2G), sub-inner limiting membrane (sub-ILM) (Figure 2H), outer plexiform layer (OPL) (Figure 3M), ellipsoid zone (EZ) (Figure 3N) and Henle fiber layer (HFL) (Figures 3O,P) hemorrhages.
case_images: Color ophthalmoscopic images of both eyes were normal (A,B). However, FAF images (C,D) and NIR images (E,F) revealed that mild retinal lesions remained. OCT (G,H) revealed slight changes in the outer retinal layers. The continuities of the EZ (G, white arrow) and interdigitation zone (H, yellow arrows) were not fully recovered.
case_images: fmed-11-1322126-g004.jpg
case_images: PMC10912278_01_fmed-11-1322126-g004.jpg
case_images: fig4
case_images: At the follow-up visit 8 months later, his visual acuity was 20/20 in both eyes, and fundus examination showed that his retinal hemorrhages were almost completely absorbed (Figures 4A,B). However, FAF (Figures 4C,D) and NIR (Figures 4E,F) imaging helped to detect that mild retinal lesions were remained. OCT through the macula also revealed changes in the outer layers of the retina (Figures 4G,H). The continuities of the EZ (Figure 4G) and interdigitation zone (Figure 4H) were not fully recovered.