case_images: PMC11202079_01
case_images: Fundus photographs of both eyes. OD, oculus dexter or right eye; OS, oculus sinister or left eye. (A) Multifocal depigmented areas (white arrowheads) in the non-tapetal fundus and several pigmented spots (white arrow) in the tapetal fundus were shown in the right eye. The features of the retinal vasculature, tapetal reflectivity, and optic disk all appeared to be within the normal variation. (B) In the left eye, an increase in the optic disk diameter, blurring of the disk margin, a change in the disk color to dark grey, multifocal depigmented areas (white arrowheads), and an increase in vascular tortuosity were observed.
case_images: fvets-11-1372802-g001.jpg
case_images: PMC11202079_01_fvets-11-1372802-g001.jpg
case_images: fig1
case_images: Other characteristics, such as vascular tortuosity and diameter, overall tapetal reflectivity, and the shape of the optic disk appeared normal (Figure 1A). Additionally, the peripapillary retina presented a darker hue and appeared blurred (Figure 1B).
case_images: Fundus photographs and cross-sectional retinal optical coherence tomography (OCT) images in the corresponding location of the right eye (A-H) and left eye (I-P). The measurement locations for retinal layer thickness and the designations of the measured retinal layers are schematically represented (A). TR, total retina; RNFL, retinal nerve fiber layer; GCC, ganglion cell complex; IR, inner retina; ONL, outer nuclear layer; OR, outer retina. In the right eye, multifocal pigmented lesions were noted in fundus photographs, aligning with the areas of retinal detachments in the OCT images (A,B). In the peripapillary region, small retinal detachment was noted despite any lesion not being shown in fundus photograph. Small retinal detachment in the non-tapetal fundus, the OCT image displayed extensive retinal detachment, exceeding the areas of the depigmented lesions seen on funduscopy (H). The configuration of Bruch's membrane layer in the peripapillary region was flat to V-shaped. In the left eye, the individual layers were not easily distinguishable, especially in the peripapillary region. A severe anterior displacement of the optic nerve head and peripapillary Bruch's membrane was evident (I-P).
case_images: fvets-11-1372802-g002.jpg
case_images: PMC11202079_01_fvets-11-1372802-g002.jpg
case_images: fig2
case_images: The right eye showed multiple small retinal detachments, each approximately 0.5-2 mm in width, in the superior retina and peripapillary regions (Figures 2A-G). However, in the inferior retina, an extensive retinal detachment measuring over 6 mm x 6 mm was noted (Figure 2H). In the left eye, severe anterior deformation of the ONH and peripapillary Bruch's membrane (pBM) was evident (Figures 2I-P).
case_images: Sagittal T1W precontrast (A), T1W postcontrast (B), transverse T2W (C), fluid-attenuated inversion recovery (FLAIR) (D), and T2* (E,F) images showing the suprasellar mass (arrows). The area within the mass was T2W and FLAIR hyperintense to the grey matter on the T2W and FLAIR, iso to hypointense on the T1W, and moderate contrast-enhancing. Additionally, a signal void artifact (red arrowhead) was shown in the T2* sequence at the cranial margin of the mass. Sagittal T2W images on magnetic resonance imaging of the eyeball in the right eye (G) and left eye (H) and optic nerve sheath on the right side (I) and left side (J). On the left side, there is a flattening/protrusion of the posterior sclera (arrow) and a slight increase in the optic nerve sheath diameter (white arrowhead) compared to the right side.
case_images: fvets-11-1372802-g003.jpg
case_images: PMC11202079_01_fvets-11-1372802-g003.jpg
case_images: fig3
case_images: The brain MRI revealed an irregular, broad-based suprasellar mass measuring a minimum of 2.68 cm in length, 1.42 cm in height, and 2.34 cm in width (Figures 3A,B). The mass was heterogeneously hyperintense to the gray matter on the T2W, FLAIR, and T2* images, isointense to hypointense on the T1W images, and exhibited moderate contrast enhancement (Figure 3B). The mass was continuous with the anterior aspect of the pituitary gland, but the posterior aspect of the pituitary gland displayed normal high signal intensity on the T1W images. The mass displaced the third ventricle dorsally and caused a mild rightward shift of the falx cerebri (Figures 3C,D), and concurrent transtentorial brain herniation was also observed. T2* sequence, indicative of hemorrhage (Figures 3E,F). There was mild hyperintensity on the FLAIR images around the peripheral margins of the mass, possibly representing interstitial edema. Flattening of the posterior sclera was observed (Figures 3G,H). Additionally, there was a mild increase in the optic nerve sheath (ONS) diameter on the left side compared to the right side (right: 2.4 mm, left: 3.0 mm; Figures 3I,J).