Título / Title

CASE REPORT: UNILATERAL ACUTE IDIOPATHIC MACULOPATHY ASSOCIATED WITH COXSACKIE VIRUS

Introdução / Purpose

Unilateral acute idiopathic maculopathy (UAIM) is an inflammatory process that involves outer retina and retinal pigment epithelium (RPE) of macula. It is a rare entity, described by Yannuzzi in 1991, characterized by non-painful unilateral low visual acuity with central or paracentral scotoma in young people, associated with viral promos.

Material e Método / Methods

Analysis of medical records from the Brazilian Center for Vision (CBV), interview with the patient and literature review.

Resultados / Results

16 year old, male, born in Brasilia, without comorbidities and ophthalmological history, with a complaint of central scotoma in the right eye for 20 days after a flu-like illness with fever. BCVA was 0.2 in righ eye and 1.0 in left eye. Biomicroscopy without changes in both eyes. Ophthalmoscopic examination in the right eye showed scar lesion in the foveal region and left eye without alterations. Complementary exams in right eye showed a rounded hyperautofluorescent juxtafoveal lesion affecting the fovea; posterior contrast impregnation; perifoveal cystic processes. Systemic and laboratory investigation revealed positive IgG for Coxsakie virus, corroborating the hypothesis of UAIM by the Coxsackie virus. After 12 months, BCVA 0.4; fundus with maintenance of juxtafoveal. OCT-A showing discontinuity of the inner retina in the central macular region with restructuring of the ellipsoid zone and external limiting membrane in the parafoveal region.

Discussão e Conclusões / Conclusion

UAIM is an entity with a good prognosis, not requiring specific treatment. there is already an association between the Coxsackie virus and other viral infections described in the literature, but the pathophysiology is still limited. Ocular manifestations and posterior segment findings may be similar in other autoimmune maculopathies, especially central serous chorioretinopathy (CSC) and idiopathic choroidal neovascularization (CNV). From a therapeutic point of view, different UAIM of CSC and CNV are of utmost importance to avoid possible complications that threaten vision.

Palavras Chave

Unilateral acute idiopathic maculopathy; Coxsakie virus; flu-like; posterior segment

Area

CLINICAL RETINA