Journal
NEURO-OPHTHALMOLOGY
Volume -, Issue -, Pages -Publisher
TAYLOR & FRANCIS AS
DOI: 10.1080/01658107.2023.2284914
Keywords
Measles virus; necrotising retinitis; optical coherence tomography; optical coherence tomography angiography; subacute sclerosing panencephalitis
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This case report describes the OCTA findings of retinal lesions in a patient with SSPE. The OCTA showed flow deficit areas and reduced vessel density. The patient presented with various neurological and neuropsychological symptoms, and brain MRI revealed non-specific small foci of T2 hyperintensity.
We present a 20-year-old woman who was diagnosed with subacute sclerosing panencephalitis (SSPE) 20 months after presenting with unilateral retinitis. At presentation, the patient had two inferotemporal macular lesions in her left eye. Corresponding to these areas, optical coherence tomography (OCT) showed hyporeflective spaces with loss of nearly all of the retinal layers. OCT-angiography (OCTA) demonstrated some flow deficit areas with a reduction in the vessel density. Her serum measles antibody titre was high (IgG >5000.0 mIU/ml). Twenty months later the macular lesions had diminished in size, and there was some focal retinal thinning with interruption of the ellipsoid zone. OCTA showed that the flow deficit areas were diminished in size together with the relatively improved perfusion density. Neurological examination disclosed myoclonic jerks. Neuropsychological assessment demonstrated impaired executive function, attention, and narrowed lexical fluency. Measles IgG antibody was high in the cerebrospinal fluid (>230.0 U/ml). Brain magnetic resonance imaging demonstrated bilateral, non-specific, small foci of T2 hyperintensity in the frontoparietal subcortical white matter and centrum semiovale. The present case is the first where OCTA findings of SSPE-related retinal lesions have been described.
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