Título / Title

MULTIMODAL ANALYSIS IN CASE OF PRESUMED ACUTE FOVEOLITIS

Introdução / Purpose

Advances in ophthalmologic imaging technology allow detailing structural changes in the retina and relating them to functional changes.

Material e Método / Methods

This paper is a prospective, observational and descriptive study, through propaeditic exams and compared with results in the literature. The patient was submitted to evaluation of visual acuity, anterior biomicroscopy, measurement of intraocular pressure (IOP), fundoscopy, OCT (optical coherence tomography), AF (fluorescein angiography), FAF (autofluorescence), VC (visual field), mfERG (multifocal electroretinogram) and OCT-A (OCT angiography).

Resultados / Results

A 49-year-old male patient complained of blurry vision in the left eye for 1 year. He denied any priors. Visual acuity of 20/25 in the right eye and 20/30 in the left eye. Anterior biomicroscopy and IOP without alterations. On fundoscopy, he presented small white-yellowish lesions in the nasal perimacular region in both eyes. In macula OCT, he presented an interruption located in the nasal parafoveolar ellipsoid zone, with hyperreflective conical lesion in the adjacent external nuclear layer in both eyes. In AF, he presented hyperfluorescent points by window defect and, in FAF, hypoautofluorescent points, both in the area corresponding to the lesion. VC 10-2 and OCT-A unchanged. In mfERG, a slight reduction in foveal response in both eyes. Biochemical and serological laboratory tests infectious and autoimmune, without alterations, with 2 doses of Covid-19 vaccine.

Discussão e Conclusões / Conclusion

Based on the clinical results, it was concluded that it was a presumed acute foveolitis, since differential diagnoses such as acute macular neuropathy and occult maculopathy were ruled out through unalterationed OCT-A and mfERG with little foveal involvement and preservation of the external nuclear layer, respectively. Toxic and solar maculopathy were ruled out due to non-exposure to causative agents. Preservation of the external retina wards off MEWDS and AZOOR. Follow-up is necessary to follow the evolution of the clinical case.

Palavras Chave

Foveolitis, maculopathy

Area

CLINICAL RETINA