Sunday, December 4, 2011

Retina and systemic disease. What do you see?

64 year old female with acute visual loss noted one week after starting treatment for strep sepsis.

1)What do you see?
2)What do you want to look at next in the work-up?

1 comment:

  1. Arteries and veins look okay to me. Cup/disk=0.4? (hard to tell, bright). There appears to be some edema (yellow on temporal half of the macula)that could accounting for this patients acute vision loss. There is also a yellow exudate just inferior to the superior temporal artery and few small ones running along the inferior temporal artery. These can bee seen on the fluorescein angiogram below. On the zoomed out image of more of the retina, orange streaks can be seen.

    Given that it is a patient just started on treatment for strep sepsis, I am led to believe this is a drug reaction. I believe penicillin is most commonly used for strep, but something more aggressive may be used if the patient is in sepsis.

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