First Author: C.K.Chan HONG KONG
Co Author(s): A. Young E. Lo H. Sin 0 0 0 0 0 0 0 0 0
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To document a case with whitish lesion at macula
A young healthy myopic gentleman presented with left eye acute paracentral scotoma, who had a whitish lesion, located juxtafoveally. His visual acuity of the affected eye was 20/40. Fundus examination revealed yellow-white lesions at the level of the inner choroid and retinal pigment epithelium.
Case report (with FA/ ICG film)
He had history of keeping tortoises as pets (which had recently treated for skin ulceration). Systemic workup was performed to rule out infection. Chest X Ray was clear, mantoux test was negative, all blood test included serology tests of toxoplasmosis, toxocara, brucellosis were all negative. Electrophysiology test were non specific : Multifocal ERG showed depressed focal response in left eye central fovea. Flurescein angiography and indocyanine green angiography showed pooling of dye and mild leakage respectively.
The lesion spontaneously resolved without treatment. And his vision returned to 20/20. The working diagnosis was punctate inner choroidopathy which is a relatively uncommon inflammatory multifocal chorioretinopathy that affects predominantly young myopic population. It is a self-limited disease with good visual prognosis.