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Bilateral Roth spots following metapneumovirus infection: A rare but underrecognized association
Thomas Foulonneau1, Tali Anne Szwebel2, Rebecca Farhat1
1Service d'ophtalmologie, AP-HP, Hôpital Cochin, Paris, 75014, France.
Purpose:
To report a case of bilateral Roth spots in an adolescent, with a recent metapneumovirus viral infection.
Observations:
A 17-year-old male consulted with painless floaters and blurred vision. Fundus examination showed bilateral Roth spots and segmental venous sheathing. An extensive systemic workup was unremarkable, including negative QuantiFERON-TB Gold testing. The patient had a recent history of viral infection, and a metapneumovirus was detected on PCR of a nasal swab.
The Retinal Lesions Resolved Spontaneously:
by day 7, visual acuity was normal and Goldmann visual field testing showed no residual defect. At the one-year follow-up, complete resolution was sustained on both color fundus photography and fundus autofluorescence, with no residual changes of the retinal pigment epithelium.
Conclusion And Importance:
This case highlights a rare association between a viral respiratory infection and Roth spots. The lesions are presumed to be due to a post-viral immune-mediated process affecting the retinal microvasculature. The rapid spontaneous resolution and the absence of long-term sequelae suggest that similar cases may go unnoticed.
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