case_images: PMC10723180_01
case_images: Multimodal imaging of patient at initial presentation. (A) Fundus photographs show optic disc edema and ovoid hypopigmented chorioretinal lesions around the optic disc and in the periphery in both eyes (OU). The right eye (OD) also showed peripapillary atrophy, macular retinal pigmental epithelium changes, and small retinal heme superotemporally. (B) SD-OCT showed optic disc elevation with peripapillary intraretinal fluid and mild epiretinal membrane (ERM) OD > OS. (C) Wide-angle fluorescein angiography showed hazy media, disc leakage around the rim and peripapillary staining OD and diffuse optic disc leakage with mild segmental staining of venules along the inferior temporal arcade OS (arrows). There was hyperfluorescence of several of the lesions in the peripapillary region and along the inferior temporal arcade without any sign of leakage OU. (D) Wide-angle indocyanine green angiography showed multiple hypocyanescent spots in the posterior pole and midperiphery in the intermediate phase of indocyanine green angiography.
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case_images: The right eye also showed temporal peripapillary atrophy, 1+ vitreous cells, macular retinal pigment epithelium pigmentary changes, and small retinal hemorrhage in the superotemporal quadrant periphery (Figure 1A). Spectral domain optical coherence tomography (SD-OCT) showed optic disc elevation in peripapillary intraretinal fluid with mild epiretinal membrane (ERM) OD > OS (Figure 1B). There was hyperfluorescence of several of the lesions in the peripapillary region and along the inferior temporal arcade without any sign of leakage OU (Figure 1C). Wide-angle indocyanine green chorioangiography (ICG) showed clear media, multiple hypocyanescent spots in the posterior pole and midperiphery in the intermediate phase, and hypocyanescent spots faded in the late phase OU (Figure 1D).
case_images: Wide-angle fluorescein angiography and wide-angle indocyanine green angiography of patient following treatment with infliximab (A) Wide-angle fluorescein angiography showed hazy media due to cataract formation, partial optic disc staining OU. There was hyperfluorescence of several of the lesions in the peripapillary region and along the inferior temporal arcade in early and late frames without any sign of leakage OU. (B) Wide-angle indocyanine green angiography showed a few hypocyanescent spots in the posterior pole in the intermediate phase of indocyanine green angiography.
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case_images: FA remained the same OU (Figure 2). Four months later, the patient received additional four cycles of IFX infusions along with 1 day of 1000 mg methylprednisolone. ICG was performed and hypocyanescent spots showed marked improvement with scattered few hypocyanescent spots at posterior pole (OS>OD) in both eyes on ICG (Figure 2).