ABSTRACT
A 13-year-old Black male patient with a history of Kikuchi-Fujimoto disease (KFD) and sickle cell trait presented with acute painless vision loss and no light perception vision (NLP) in his left eye. The examination was indicative of occlusive retinal vasculitis with near total central retinal artery occlusion (CRAO). He was started on oral steroids with dramatic reperfusion and improvement of the retinal hemorrhages. However, his vision remained at NLP. Oral steroids were tapered, and rituximab infusion was initiated. While ocular involvement is uncommon in KFD, vision-limiting complications, such as occlusive retinal vasculitis, ophthalmic artery occlusion, and CRAO can occur. Early systemic immunosuppression is key in achieving rapid remission. [Ophthalmic Surg Lasers Imaging Retina 2024;55:235-239.].
Subject(s)
Fluorescein Angiography , Histiocytic Necrotizing Lymphadenitis , Retinal Vasculitis , Sickle Cell Trait , Humans , Male , Histiocytic Necrotizing Lymphadenitis/diagnosis , Histiocytic Necrotizing Lymphadenitis/complications , Histiocytic Necrotizing Lymphadenitis/drug therapy , Sickle Cell Trait/complications , Sickle Cell Trait/diagnosis , Retinal Vasculitis/diagnosis , Retinal Vasculitis/etiology , Adolescent , Fluorescein Angiography/methods , Visual Acuity , Retinal Artery Occlusion/diagnosis , Retinal Artery Occlusion/etiology , Fundus Oculi , Glucocorticoids/therapeutic use , Glucocorticoids/administration & dosageABSTRACT
PURPOSE: To report a series of cases with smokestack leakage on fundus fluorescein angiography outside the clinical setting of central serous chorioretinopathy. METHODS: A multicenter, observational retrospective case series evaluating fundus fluorescein angiography on Topcon and Optos systems. RESULTS: Seven patients with neovascularization due to ischemic retinopathy demonstrated a unique smokestack pattern of angiographic leakage. The patients' ages ranged between 44 and 71 years and were seen at 3 academic teaching hospitals in the Washington-Baltimore metropolitan area. Five patients had been diagnosed with proliferative diabetic retinopathy, one with sickle cell ischemic retinopathy, and one with branch retinal artery occlusion; none of the patients had a known history or clinical signs of current or past central serous chorioretinopathy. CONCLUSION: This is the first published case series to the author's knowledge of ischemic retinopathy displaying a smokestack leakage pattern on fundus fluorescein angiography that is classically described with idiopathic central serous chorioretinopathy.
