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Posterior Segment Involvement in Subacute Sclerosing Panencephalitis: Clinical Features and Outcomes.

Feyza Onder¹, Abdullah Ağın¹, Dilhan Karaca¹

¹Department of Ophthalmology, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey.

Ocular Immunology and Inflammation

|April 18, 2026

Summary

Posterior segment eye findings in subacute sclerosing panencephalitis (SSPE) are diverse and can appear before neurological symptoms. Advanced imaging like OCT and FFA aids in early SSPE diagnosis and management.

Keywords:

Chorioretinitis multimodal imaging posterior segment involvement subacute sclerosing panencephalitis visual impairment

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Area of Science:

Ophthalmology
Neurology
Medical Imaging

Background:

Subacute sclerosing panencephalitis (SSPE) is a rare, progressive neurological disorder.
Posterior segment ocular manifestations of SSPE are not well-characterized.
Early diagnosis of SSPE is crucial for potential management and improved outcomes.

Purpose of the Study:

To characterize posterior segment ocular involvement in SSPE.
To evaluate the utility of multimodal imaging in diagnosing SSPE.
To correlate ocular findings with clinical outcomes in SSPE patients.

Main Methods:

Retrospective review of three SSPE patients with posterior segment findings.
Ophthalmic examination, fundus photography, fundus fluorescein angiography (FFA), and optical coherence tomography (OCT) were performed.
Neurological assessment and clinical outcomes were analyzed.

Main Results:

Variable posterior segment involvement observed, including macular chorioretinitis, RPE alterations, macular edema, hemorrhages, and retinal detachment.
Ocular findings preceded or aided in the suspicion of SSPE in two patients.
OCT revealed characteristic intraretinal degeneration patterns; visual improvement was limited, with two patients experiencing neurological decline.

Conclusions:

Posterior segment findings in SSPE are heterogeneous and can precede neurological symptoms.
Multimodal imaging (OCT, FFA) offers valuable diagnostic insights for SSPE.
Early recognition of ocular signs may facilitate timely SSPE diagnosis and management.