Choroidal Vascular Changes in Acute Idiopathic Maculopathy as Demonstrated by Multimodal Imaging including Optical Coherence Tomography Angiography

Tahsin Khundkar; Syed R Hasan; Mark P Breazzano; Constance Mei; Brandon B Johnson

doi:10.1155/2021/6680020

Choroidal Vascular Changes in Acute Idiopathic Maculopathy as Demonstrated by Multimodal Imaging including Optical Coherence Tomography Angiography

Case Rep Ophthalmol Med. 2021 Apr 6:2021:6680020. doi: 10.1155/2021/6680020. eCollection 2021.

Authors

Tahsin Khundkar¹, Syed R Hasan², Mark P Breazzano³, Constance Mei⁴, Brandon B Johnson⁵

Affiliations

¹ Department of Ophthalmology, University of Minnesota, 516 Delaware Street SE, Minneapolis, MN 55455, USA.
² AdvantageCare Physicians, 180-05 Hillside Avenue, Queens, NY 11432, USA.
³ Department of Ophthalmology, Johns Hopkins University School of Medicine, 87 Thomas Johnson Drive, Frederick, MD 21702, USA.
⁴ Department of Ophthalmology, New York Medical College-Jamaica Hospital Medical Center, 134-20 Jamaica Avenue, Richmond Hills, NY 11418, USA.
⁵ New York Retina Center, 161 E 32nd St, New York, NY 10016, USA.

Abstract

Purpose. To present a case of acute idiopathic maculopathy (AIM) and illustrate primary choroidal perfusion defect using multimodal imaging. Case Description. We report a case of a 24-year-old man with a paracentral scotoma of the right eye and recent flu-like illness. The patient was found to have a unilateral ovoid-shaped, placoid lesion just inferior to the fovea. Multimodal imaging confirmed findings most consistent with a diagnosis of acute idiopathic maculopathy (AIM). Serologic studies confirmed a strongly positive immunoglobulin G (IgG) titer for coxsackievirus A. Spectral-domain optical coherence tomography angiography (SD-OCTA) showed bilateral areas of vascular reduction at the level of the choriocapillaris and choroid, sparing the retinal circulation. Conclusions and Importance. The changes in outer retina and retinal pigment epithelium, classically described in AIM, are likely secondary to choroidal hypoperfusion.

Publication types

Case Reports