A 29-year-old white male was referred with recent onset central vision loss in the right eye for one week. The patient noticed the symptoms while suffering from fever secondary to hand, foot, and mouth disease.
Other medical and past ocular history was unremarkable other than contact lens wear for myopia.
Previously from Dr. Rafieetary: Misdiagnosing macular degeneration
Best-corrected visual acuity was 20/400 in the right eye and 20/30 in the left eye.
Intraocular pressures were measured at 13 mm Hg in the right eye and 11 mm Hg in the left eye.
Pupillary testing, ocular movements, confrontation visual fields, and anterior segment findings were all unremarkable.
Fundus exam of the right eye was remarkable for macular pigment mottling with all other structures being normal. The left eye exhibited a normal fundus exam.
Fundus autofluorescence (FAF) (see Figure 1) shows a circular area of mottled pigmentation surrounding the fovea, while the left eye was normal.
Optical coherence tomography (OCT) was remarkable for alteration of the outer retina. Note the changes in the retinal pigment epithelium (RPE) and photoreceptor region in an approximately 3000 µm radius around the fovea (see Figure 2).
This patient has suffered acute viral maculopathy in the right eye.