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Complete Visual Recovery From Severe Outer Retinitis After Tonsillitis.

Rumi Kawashima1, Kenji Matsushita, Noriyasu Hashida

  • 1Department of Ophthalmology (RK, KM, NH, KN), Osaka University Graduate School of Medicine, Osaka, Japan; Department of Ophthalmology (KK), Kindai University Faculty of Medicine, Osaka-Sayama City, Japan; Osaka University Graduate School of Frontier Biosciences (TF), Osaka, Japan; and Integrated Frontier Research for Medical Science Division (KN), Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Japan.

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Summary

Severe acute bilateral outer retinitis, a vision-threatening condition, can fully recover with prompt steroid treatment. This case highlights the potential for significant visual and anatomic improvement even in severe outer retinitis.

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Area of Science:

  • Ophthalmology
  • Retinal Diseases
  • Immunology

Background:

  • Reports a case of severe acute bilateral outer retinitis following tonsillitis.
  • Highlights the potential autoimmune link in post-tonsillitis retinal inflammation.

Observation:

  • A 26-year-old woman presented with acute bilateral blurred vision post-tonsillitis.
  • Spectral-domain optical coherence tomography (SD-OCT) revealed photoreceptor outer segment damage.
  • Electroretinography (ERG) was nonrecordable, indicating severe retinal dysfunction.

Findings:

  • The patient experienced remarkable anatomic and functional recovery with steroid treatment.
  • SD-OCT showed residual macular damage, and adaptive optics imaging confirmed cone photoreceptor damage.
  • Prednisolone demonstrated efficacy in treating this outer retinitis case.

Implications:

  • Early diagnosis and prompt steroid intervention are crucial for managing severe outer retinitis.
  • Suggests outer retinitis may involve autoimmune mechanisms, responding well to immunosuppressive therapy.
  • Even severe cases can achieve substantial recovery, underscoring the importance of timely treatment.