Abstract

Objective

To describe a case of Behçet disease (BD) uveitis manifesting with sequential bilateral neuroretinitis associated with prepapillary inflammatory vitreous exudate (PIVE).

Material and methods

A single case report documented with multimodal imaging.

Results

A 37-year-old man developed neuroretinitis with associated PIVE in the left eye. He was diagnosed with ocular toxoplasmosis and treated accordingly based on positive serologic testing and negative work-up for other entities, including BD. The disease course was favorable, but 1 year later a similar neuroretinitis developed in the right eye. Extraocular features of BD became evident only at the time of the second eye involvement, and the patient received corticosteroid and immunosuppressive therapy.

Swept source (SS) OCT showed at the acute phase in both eyes a typical “mushroom-shaped” prepapillary hyperreflectivity of the PIVE. SS OCT angiography (OCTA) demonstrated a corresponding prepapillary hypointense area due to shadowing effect, decreasing in size while scanning deeper layers. It also detected peripapillary retinal hypervascularity in both eyes and a sectoral area of flow signal loss in the first involved left eye. Visual acuity improved following the resolution of the PIVE and associated acute inflammatory changes in both eyes. The left eye showed residual optic disc pallor and retinal nerve fiber layer defects.

Conclusion

Sequential bilateral neuroretinitis associated with PIVE may occur before other clinical features of BD become evident. SS OCT and OCTA can provide useful information for the diagnosis and management of this rare, but typical, ocular manifestation of BD uveitis.

Details

Title
Sequential bilateral Behçet’s neuroretinitis associated with prepapillary vitreous exudate: case report
Author
Ksiaa Imen 1 ; Ben Aoun Safa 1 ; Sourour, Zina 1 ; Nefzi Dhouha 1 ; Khochtali Sana 1 ; Khairallah Moncef 1 

 University of Monastir, Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, Monastir, Tunisia (GRID:grid.411838.7) (ISNI:0000 0004 0593 5040) 
Publication year
2020
Publication date
Dec 2020
Publisher
Springer Nature B.V.
e-ISSN
18695760
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2473371538
Copyright
© The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.