[A case of subacute bacterial endocarditis showing acute macular neuroretinopathy-like lesions].

Nippon Ganka Gakkai Zasshi

Department of Ophthalmology, Surugadai Hospital of Nihon University, 1-8-13 Kannda-surugadai, Chiyoda-ku, Tokyo 101-8309, Japan.

Published: May 2001

Purpose: We report one case of mimic fundus lesions with acute macular neuroretinopathy due to subacute bacterial endocarditis.

Case: A 55-year-old male had about a 1 DD reddish petal-shaped lesion at the level of the retinal pigment epithelium in the macula and a white lesion about 1/6 DD at the level of the retinal pigment epithelium in the upper fovea. Fluorescein angiography showed the reddish lesion to be hypofluorescence due to a filling defect and indocyanine green angiography showed the hypofluorescence was due to a circulatory disturbance of the choriocapillaris. Additionally, we found that there was a severe choroidal circulatory obstruction in the white lesion on the retinal pigment epithelium. After the disappearance of the white lesion, secondary retinal pigment epithelium atrophy remained.

Conclusion: The macular lesions of acute macular neuroretinopathy were ischaemic lesions of the retinal pigment epithelium formed because of a disturbance at the level of the choriocapillaris.

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