Diagnostic and therapeutic challenges

摘要

A 26-year-old woman presented with a 3-day history of blurred vision in her left eye. The patient's ocular and medical histories were unremarkable. There was no family history of retinal disease. She denied long-term use of any medications including corticoste-roids but had received the human papilloma virus vaccination 1 month before presentation. Examination revealed best-corrected visual acuities of 20/20 in the right eye and 20/30 in the left eye with a correction of -2.25 + 1.75 x 103 diopters in the right eye and -1.75 + 2.25 x 84 diopters in the left eye. The anterior segment examination was normal. Intraocular pressures were 13 mmHg in each eye. Funduscopic examination showed subtle pigmentary changes in the macula of the right eye (Figure 1A) and a small yellowish lesion with overlying subretinal edema without hemorrhage inferonasal to the foveE in the left eye (Figure 1B). There was no vitritis in either eye Figure 2 shows the optical coherence tomography (OCT) findings in the left eye. Enhanced depth imaging OCT showed bilaterall) symmetric choroidal thickening measuring 500 mum. Figure 3, A and B show the fluorescein angiographic findings. Figure 4, A anc B shows the indocyanine green angiographic findings.