Diagnostic and therapeutic challenges.

摘要

A 52-year-old woman presented with acute unilateral visual ioss in the left eye in January 2005. Best-corrected visual acuity was 20/25 in the right eye and barely counting fingers in the left eye. Clinical examination showed clear corneas but mild flare and cells in the anterior chamber of the ieft eye. The posterior segment of the right eye was entirely normal. There was a prominent juxtapapil-lary and macular granulomatous lesion extending from the retina into the vitreous cavity that was associated with hemorrhage and surrounded by dense subretinal exudates in the left eye (Fig. 1). Fluorescein angiography of the left eye showed hypofluorescence of the granuloma with surrounding hazy staining and leakage (Fig. 2). Optical coherence tomography showed vitreoretinal traction around the apex of the granuloma (Fig. 3). Over the subsequent months, there was progressive shrinkage of the granulomatous lesion and consolidation of the surrounding exudates with increased fibrosis (Fig. 4). During the most recent evaluation in April 2005, best-corrected visual acuity remained counting fingers in the left eye.