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Bilateral asynchronous acute idiopathic maculopathy with disease recurrence.
Yichen Fan1, Zachary A Kroeger1, Christina J Flaxel1
1Casey Eye Institute at Oregon Health and Science University, 515 SW Campus Dr., Portland, OR, 97239, USA.
American Journal of Ophthalmology Case Reports
|October 29, 2024
Summary
This case study details a young male with recurrent, bilateral acute idiopathic maculopathy (AIM), a rare posterior segment eye disorder. The patient experienced multiple episodes in both eyes, highlighting the condition's potential for recurrence and bilateral involvement.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Neuro-ophthalmology
Background:
- Acute idiopathic maculopathy (AIM) is a posterior segment disorder affecting the neurosensory retina, retinal pigment epithelium, and choroidal circulation.
- While initially described as unilateral, AIM has been reported with bilateral presentations, and viral etiologies like coxsackie virus are suspected, alongside other pro-inflammatory conditions.
Observation:
- A 35-year-old male presented with unilateral retinal whitening, diagnosed as AIM via multimodal imaging showing bacillary layer detachment and choriocapillaris disruption.
- The condition resolved with steroid treatment, but recurred bilaterally over three years, with imaging showing increasing affected areas, though visual acuity returned to baseline.
Findings:
- This report describes a unique case of recurrent, bilateral acute idiopathic maculopathy in a young male without a preceding viral illness.
- Multimodal imaging across multiple episodes provided detailed insights into the evolving pathology of the recurrent and bilateral AIM.
Implications:
- The recurrent and bilateral nature of AIM in this patient, coupled with multimodal imaging findings, suggests a potential link between AIM and the spectrum of white dot diseases.
- This case expands the understanding of AIM's clinical presentation and underscores the importance of comprehensive imaging and follow-up for diagnosing and managing this condition.
