ABSTRACT
BACKGROUND: To describe a case of bilateral multifocal chorioretinitis as the only presentation of acute West Nile virus (WNV) infection in the absence of neurological involvement. CASE PRESENTATION: A 78-year-old Italian woman was admitted to our emergency department because she noticed blurry vision in both eyes. She did not report fever, fatigue, or neurological symptoms in the last few days. Multimodal imaging showed the presence of bilateral hyperfluorescent lesions with a linear distribution, that corresponded to hypocyanescent spots on indocyanine green angiography. Antibody serology showed the presence of IgM antibodies, IgG antibodies, and ribonucleic acid (RNA) for WNV. Magnetic resonance imaging (MRI) of the brain ruled out central nervous system involvement. Three months later, the patient reported spontaneous resolution of her symptoms and remission of the chorioretinal infiltrates. CONCLUSIONS: In endemic areas, it is important to think of acute WNV infection as an explanatory etiology in cases of multifocal chorioretinitis, even without neurological involvement.
Subject(s)
Chorioretinitis , Eye Infections, Viral , West Nile Fever , West Nile virus , Humans , Female , Aged , West Nile Fever/complications , West Nile Fever/diagnosis , West Nile Fever/epidemiology , Eye Infections, Viral/diagnosis , Chorioretinitis/etiology , Vitreous Body/pathology , Antibodies, ViralSubject(s)
Adenocarcinoma/drug therapy , Carcinoma, Non-Small-Cell Lung/drug therapy , ErbB Receptors/metabolism , Lung Neoplasms/drug therapy , Piperazines/therapeutic use , Protein Kinase Inhibitors/therapeutic use , Acrylamides , Adenocarcinoma/pathology , Adenocarcinoma of Lung , Aniline Compounds , Carcinoma, Non-Small-Cell Lung/pathology , Female , Humans , Lung Neoplasms/pathology , Middle Aged , Neoplasm Metastasis , Piperazines/pharmacology , Protein Kinase Inhibitors/pharmacologyABSTRACT
PURPOSE: To report the capability of autofluorescence as a novel approach to diagnosing macular holes. DESIGN: Observational case report. METHODS: In an institutional study, autofluorescence photos and optical coherence tomography scans of two patients who had surgery for macular holes were reviewed. RESULTS: Macular hole cases had a strong subfoveal autofluorescence signal, which disappeared after surgical closure of the macular hole. CONCLUSIONS: Autofluorescence is a novel approach to demonstrating a macular hole. This technique can also be used to confirm postoperative outcome after macular hole repair. A lack of autofluorescence corresponds to macular hole closure.
