Case 9-10. Progressive Outer Retinal Necrosis
A 42-year-old man with human immunodeficiency virus (HiV) was referred for decreasing vision, flashes, and floaters in his right eye over the past month. On examination, the visual acuity in this eye was 20/100, Slit-lamp biomicroscopy (A) showed mild macular edema and a yellow subretinal lesion involving the fovea. Several other chorioretinal lesions were identified in the mid-periphery. A clinical diagnosis of progressive outer retinal necrosis was established.
Macular thickening and subretinal fluid accumulation were identified on OCT (BX The tomogram also delineated a focal area of enhanced backscattering from the outer retinal layers directly beneath the fovea. The reflection from the retinal pigment epithelium (RPE) appeared to be reduced in this area, due to either primary involvement of the RPE cells, or shadowing from the lesion above,
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