The Calm Before the Storm? An Unusual Case of Measles Retinopathy

A 30-year-old male presented with sudden painless loss of vision in the right eye for the last two days. Slit-lamp examination of the right eye revealed a quiet anterior chamber and anterior vitreous. Fundus examination of the right eye revealed a large, focal retinitis lesion centered around the fovea, whereas examination of the left was unremarkable. He gave us a history of Measles at the age of 5 years but denied any history of systemic illness. Optical coherence tomography (OCT) revealed disruption of retinal architecture with ballooning of intact internal limiting membrane. His serology was negative for syphilis, human immunodeficiency virus and toxoplasmosis. Based on clinical suspicion, he was investigated by a neurologist. His electroencephalogram and Magnetic Resonance Imaging of brain were within normal limits, but high titres of anti-measles antibodies were found in serum and cerebrospinal fluid. The diagnosis of measles retinopathy should be considered in cases with focal necrotizing retinitis, even when classical findings of CNS involvement do not exist.