case_images: PMC10995331_01
case_images: Color fundus on PSO 11 OD (A), OS (B), PSO 16 OD (C), and OS (D). The nasal disc hyperemia and narrower disc cupping (OU) are more prevalent when compared with the resolution stage on PSO 16. Fluorescent angiography on PSO 16; OD at 0'51" (E), OS at 2'05"(F), OD at 6'33" (G), and OS at 5'18" (H) showed late vascular leakage from the retinal vessels and disc. Automated perimetry on PSO 17 OD (I), OS (J) showed enlarged blind spot OU. All image indicates signs of retinal vasculitis and disc inflammation (optic papillitis).
case_images: fmed-11-1379429-g0001.jpg
case_images: PMC10995331_01_fmed-11-1379429-g0001.jpg
case_images: F1
case_images: Fundus examination (Figures 1A, B) and optical coherence tomography (OCT, Figures 2A, B, 3) showed macular edema, disc hyperemia on both eyes (Oculus Uterque, OU) with ellipsoid zone (EZ) infiltration, and probably involving the choriocapillaris OS. Magnetic resonance imaging (MRI) of the head was also performed, but no evidence of active ON is present (Supplementary Figure 1). Color fundus (Figures 1C, D) on PSO 16 found macular and perimacular edema. Fluorescent angiography (Figures 1E-H) and OCT (Figures 2C, D) on PSO 16 showed capillary leakage, vitreous opacity OS, and late staining at disc OU. Visual field examination (Figures 1I, J) on PSO 17 showed an enlarged blind spot OS with a mean deviation (MD) of -4.86 decibels (dB).
case_images: OCT on PSO 11 OD (A), OS (B) reveals intraretinal fluid (orange arrow), hyperreflective materials in the superficial, deep retina, and choroid OU, especially at the EZ OS (yellow dot arrow). OCT on PSO 16 OD (C), OS (D) show similar hyperreflective materials OU (yellow dot arrow) and vitreous hyperreflective foci OD [(D), green dash arrow].
case_images: fmed-11-1379429-g0002.jpg
case_images: PMC10995331_01_fmed-11-1379429-g0002.jpg
case_images: F2
case_images: Fundus examination (Figures 1A, B) and optical coherence tomography (OCT, Figures 2A, B, 3) showed macular edema, disc hyperemia on both eyes (Oculus Uterque, OU) with ellipsoid zone (EZ) infiltration, and probably involving the choriocapillaris OS. Fluorescent angiography (Figures 1E-H) and OCT (Figures 2C, D) on PSO 16 showed capillary leakage, vitreous opacity OS, and late staining at disc OU.
case_images: EN FACE OS on PSO 13 showed vascular damage from the superficial retina down to choriocapillaris.
case_images: fmed-11-1379429-g0003.jpg
case_images: PMC10995331_01_fmed-11-1379429-g0003.jpg
case_images: F3
case_images: Fundus examination (Figures 1A, B) and optical coherence tomography (OCT, Figures 2A, B, 3) showed macular edema, disc hyperemia on both eyes (Oculus Uterque, OU) with ellipsoid zone (EZ) infiltration, and probably involving the choriocapillaris OS.
case_images: The clinical course of our case, with presentation of visual impairment since PSO 10, 3 days after the platelet count nadir. After aggressive treatment with topical, intravenous, and systemic corticosteroids, visual acuity improved but was limited in OS.
case_images: fmed-11-1379429-g0004.jpg
case_images: PMC10995331_01_fmed-11-1379429-g0004.jpg
case_images: F4
case_images: The patient is currently on low-dose oral corticosteroids with a maintenance dosage of 5 mg on PSO 59 (Figure 4).