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Rickettsial Post Fever Retinitis leading to sequential macular hole - a rare clinical trajectory

Shishir Verghese1, Geethu Subash2, Verghese Joseph1

  • 1Consultant Vitreoretinal Surgeon, Department of Vitreoretinal Services, Amita Eye Care, Tiruvalla, Kerala, India.

Retinal Cases & Brief Reports
|November 17, 2025
PubMed
Abstract

Insights

Rickettsial post fever retinitis (PFR) can rarely lead to full thickness macular holes (FTMH). This case highlights the importance of monitoring for this vision-threatening complication.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Retinal Diseases

Background:

  • Rickettsial post fever retinitis (PFR) is an uncommon ocular manifestation of rickettsial infections.
  • Macular involvement, including cystoid macular edema (CME), can occur in PFR.

Purpose of the Study:

  • To document a rare case of full thickness macular hole (FTMH) formation following PFR.
  • To emphasize the need for vigilant monitoring and tailored treatment in PFR patients.

Main Methods:

  • A case report of a 65-year-old male diagnosed with bilateral Rickettsial PFR.
  • Utilized multimodal imaging, including color fundus photography, SD-OCT, and OCT angiography, for analysis.
  • Monitored clinical progression and response to treatment.

Main Results:

  • The patient presented with bilateral PFR, vitritis, multifocal posterior pole lesions, and CME.
  • One eye progressed to develop a FTMH during treatment.
  • The other eye showed visual recovery.

Conclusions:

  • FTMH is a rare but significant sequela of Rickettsial PFR.
  • Close follow-up and individualized treatment are crucial for managing PFR and preventing vision loss.
  • Further case documentation is needed to improve understanding and management of this complication.
Keywords:
Rickettsial post fever retinitis Macular hole Uveitis

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