case_images: PMC10759205_01
case_images: Temporal artery biopsy showing extensive circumferential calcification of the media with some associated intimal hyperplasia.
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case_images: Figure7
case_images: She had advanced cataracts bilaterally, and fundal examination demonstrated left optic nerve head swelling, cotton wool spots in the cilioretinal artery distribution, and background bilateral moderate NPDR (Figure 1).
case_images: Color fundus photo of the left eye showing optic nerve head swelling, cotton wool spots along the cilioretinal artery distribution, and background moderate non-proliferative diabetic retinopathy.
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case_images: Figure1
case_images: Fundus fluorescein angiography (FFA) revealed nasal choroidal non-perfusion, disc leak, and cilioretinal artery occlusion (Figure 2).
case_images: Fundus fluorescein angiography (FFA) at (A) 17 seconds showing nasal choroidal non-perfusion and (B) 5 minutes, showing disc leakage and late staining at the cilioretinal artery distribution.
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case_images: Figure2
case_images: Repeat TAB on the right confirmed the diagnosis of calciphylaxis, showing severe circumferential arterial calcification and marked intimal thickening, and no convincing evidence of vasculitis (Figure 3).
case_images: PMC10759205_02
case_images: Temporal artery biopsy showing severe calcification and marked intimal thickening within the media and outer intima.
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case_images: Figure3
case_images: Anterior segments were unremarkable, with fundoscopy demonstrating left inferior pallid disc swelling with a cherry-red macula suggestive of central retinal artery occlusion (CRAO) (Figure 4B). Incidentally, circumferential right optic disc swelling was noted on the contralateral side (Figure 4A).
case_images: Color fundus photos demonstrating right circumferential (A) optic disc swelling with small superior disc flame hemorrhage and left (B) inferior pallid disc swelling, widespread retinal pallor with a cherry-red macula suggestive of central retinal artery occlusion.
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case_images: Figure4
case_images: Ancillary testing with Spectral domain optical coherence tomography (SD-OCT) showed marked circumferential thickening of the right retinal nerve fibre layer (RNFL) with macular sparing, and left macula hyper-reflectivity with signal increase and loss of distinction of the inner retinal layers (Figure 5).
case_images: Spectral domain optical coherence tomography (SD-OCT) scans of the macula, demonstrating right (A) nasal Retinal nerve fibre layer (RNFL) thickening not involving the macula with normal foveal contour and (B) left macula hyper-reflectivity with signal increase and loss of distinction of the inner retinal layers.
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case_images: Figure5
case_images: FFA demonstrated delayed choroidal filling with disc hyper-fluorescence and late patchy venous staining in the right eye (Figure 6A). In the left eye, there was significant delayed choroidal filling and delayed arteriovenous transit time (Figure 6B).
case_images: Fundus fluorescein angiography (FA) delayed choroidal filling with disc hyper-fluorescence and late patchy venous staining in the right eye (A) and delayed choroidal filling and delayed arteriovenous transit time in the left eye (B).
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case_images: Figure6