A 29-year-old white male presents with a small, stationary blurred spot in the center of his vision in the right eye that has been present for the past 2 weeks. Prior to onset of symptoms, he had recently recovered from a flu-like illness. He is otherwise healthy and reports no known past ocular history. He is a lawyer and reports a large amount of stress at work, and admits to a “Type-A personality”. Uncorrected visual acuity is 20/20 in the right eye and 20/20 in the left eye. Pupils are equal and there is no relative afferent pupillary defect (RAPD). Intraocular pressures are 19 and 20 in the right and left eyes respectively. Anterior segment slit-lamp exam is unremarkable bilaterally, the media is clear, and fundus exam shows a comma-shaped yellowish macular lesion with associated foveolar pigment irregularity in the right eye. OCT shows disruption of the IS/OS junction, an irregular retinal pigment epithelium (RPE) and a hyperreflective material at the level of the RPE. Fluorescein angiography (FA) shows an area of hyperfluorescence in the macula in the early and late phases without leakage. The left eye appears normal.

8 comments

Thoughts? Please leave a comment...