Catherine B Meyerle1, Lawrence A Yannuzzi. 1. From the Vitreous-Retina-Macula Consultants of New York and the LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear & Throat Hospital, New York, New York.
Abstract
PURPOSE: To describe a case of acute idiopathic maculopathy (AIM) with positive antibody titers indicative of acute infection with coxsackievirus, the suspected etiology of this disorder. METHODS: A 15-year-old boy presented with acute severe central visual loss in the left eye after a sore throat with pustular lesions. Visual acuity was 20/200, and fundus examination revealed a pigmented plaque at the level of the retinal pigment epithelium with an overlying neurosensory detachment. RESULTS: Titers of antibody to coxsackievirus, measured by complement fixation testing, were positive for acute infection with coxsackievirus B1. Our treatment recommendation was observation. In a few weeks, visual acuity spontaneously returned to 20/20 as the exudative changes resolved leaving only a bull's eye-type lesion. CONCLUSION: Determination of titers of antibody to coxsackievirus, as shown by our case, is a useful laboratory test along with careful fundus biomicroscopy and history taking to confirm a clinical suspicion for AIM.
PURPOSE: To describe a case of acute idiopathic maculopathy (AIM) with positive antibody titers indicative of acute infection with coxsackievirus, the suspected etiology of this disorder. METHODS: A 15-year-old boy presented with acute severe central visual loss in the left eye after a sore throat with pustular lesions. Visual acuity was 20/200, and fundus examination revealed a pigmented plaque at the level of the retinal pigment epithelium with an overlying neurosensory detachment. RESULTS: Titers of antibody to coxsackievirus, measured by complement fixation testing, were positive for acute infection with coxsackievirus B1. Our treatment recommendation was observation. In a few weeks, visual acuity spontaneously returned to 20/20 as the exudative changes resolved leaving only a bull's eye-type lesion. CONCLUSION: Determination of titers of antibody to coxsackievirus, as shown by our case, is a useful laboratory test along with careful fundus biomicroscopy and history taking to confirm a clinical suspicion for AIM.
Authors: Alexa L Li; Neal V Palejwala; Jessica G Shantha; Ghazala O'Keefe; Cecilia S Lee; Thomas Albini; Steven Yeh Journal: PLoS One Date: 2020-08-24 Impact factor: 3.752