ACUTE EXUDATIVE POLYMORPHOUS VITELLIFORM MACULOPATHY ASSOCIATED WITH PRIMARY EPSTEIN-BARR VIRUS INFECTION

Area of Science:

• Ophthalmology
• Virology
• Medical Imaging

Background:

• Acute exudative polymorphous vitelliform maculopathy (AEPVM) is a rare condition affecting the macula.
• Primary Epstein-Barr virus (EBV) infection is a common viral illness, typically causing infectious mononucleosis.

Observation:

• A case report details a 24-year-old woman with acute visual disturbance and cervical lymphadenopathy.
• Multimodal imaging revealed bilateral foveal serous retinal detachment (SRD) and ellipsoid zone thickening.
• Systemic evaluation confirmed acute EBV infection.

Findings:

• The SRDs evolved into multifocal lesions with subretinal hyperreflective material, characteristic of vitelliform material.
• Fundus autofluorescence showed hyperautofluorescence, while angiography demonstrated mild hyperfluorescence without leakage.
• The vitelliform material and SRDs resolved over 8 months, with normalization of the ellipsoid zone and visual acuity.

Implications:

• This case suggests a potential association between acute EBV infection and acute exudative polymorphous vitelliform maculopathy.
• Findings indicate transient RPE dysfunction and reduced photopigment density during the acute phase.
• The natural resolution of the condition highlights the importance of multimodal imaging in diagnosis and monitoring.