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MULTIMODAL IMAGING IN ACUTE RETINAL NECROSIS PRESENTING WITH MACULAR INVOLVEMENT
Jay C Wang1, Yifan Lu, Lucia Sobrin
1Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
Retinal Cases & Brief Reports
|February 8, 2020
Summary
This case report details early macular necrosis in acute retinal necrosis (ARN), a rare presentation. Multimodal imaging, including OCT angiography, revealed novel findings in the choriocapillaris, aiding diagnosis and treatment.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Infectious Eye Diseases
Background:
- Acute retinal necrosis (ARN) is a severe necrotizing retinitis, typically presenting with peripheral retinal lesions.
- Early macular involvement in ARN is uncommon and can complicate diagnosis.
Observation:
- A healthy 31-year-old woman presented with photophobia and central scotoma, showing vitritis and a macular lesion without initial peripheral findings.
- Peripheral retinal involvement manifested four days after initial symptoms.
Findings:
- Optical coherence tomography (OCT) demonstrated inner and outer retinal involvement in the macula.
- OCT angiography revealed a previously undescribed large flow void in the choriocapillaris, indicating choroidal compromise.
Implications:
- This case highlights the importance of considering macular necrosis in atypical ARN presentations.
- Multimodal imaging, particularly OCT angiography, provides crucial diagnostic insights into the extent of vascular and retinal damage in ARN.
