case_images: PMC9149546_01
case_images: Color fundus photography (Optos, Daytona; Optos PLC) of the left eye at admission. Two isolated CWS are visible at the posterior pole (white arrows), indicating focal ischemia at the inner retinal layers. The blue arrow indicates an artefact due to light reflection. There was also evidence of diffuse arteriolar vasoconstriction.
case_images: cop-0013-0297-g01.jpg
case_images: PMC9149546_01_cop-0013-0297-g01.jpg
case_images: F1
case_images: Daytona; Optos PLC, Dunfermline, UK) at admission. Despite no visual symptoms, fundus photography revealed two CWS in the posterior pole of his left eye (Fig. 1).
case_images: Color fundus photography (Topcon DRI OCT Triton; Topcon, Corp., Tokyo, Japan) of the left eye at follow-up 7 days after admission. Four isolated CWS are visible at the posterior pole. The two CWS noticed at admission (white arrow) and the two new CWS (green arrow).
case_images: cop-0013-0297-g02.jpg
case_images: PMC9149546_01_cop-0013-0297-g02.jpg
case_images: F2
case_images: The left eye showed two additional, isolated CWS not present at admission (Fig. 2).
case_images: Composite photo 7 days after admission to hospital. Color fundus photo showing four CWS at the posterior pole (top left). Red free photo showing 4 CWS (top center). OCT B-scan through one CWS showing thickening of the inner retinal layers indicating accumulation of axoplasmic debris and intracellular edema within the retinal nerve fiber and ganglion cell layers (bottom). Color coded thickness map highlighting the 4 isolated four hot-thickened areas of axoplasmic debris (top right).
case_images: cop-0013-0297-g03.jpg
case_images: PMC9149546_01_cop-0013-0297-g03.jpg
case_images: F3
case_images: OCT B-scan through one CWS showing thickening of the inner retinal layers indicating accumulation of axoplasmic debris and intracellular edema within the retinal nerve fiber and ganglion cell layers (Fig. 3). OCT B-scan through the same CWS as in Figure 3 shows a hyperreflective sign associated to the median layers neuronal cell loss (bipolar or amacrine cells) which correspond to disruption of the inner retinal layers previously occupied by the CWS (Fig. 5).
case_images: Color fundus photography (Topcon DRI OCT Triton, Topcon, Corp.) of the left fundus 3 months after admission. All CWS regressed with no visible sign of retinopathy.
case_images: cop-0013-0297-g04.jpg
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case_images: F4
case_images: Fundus examination of the left eye showed complete resolution of isolated CWS; however, diffuse arteriolar vasoconstriction could still be recognized as seen at admission, 3 months earlier (Fig. 4).