Physical Address

304 North Cardinal St.
Dorchester Center, MA 02124

Relentless (Ampiginous) Placoid Chorioretinitis


History of Present Illness

A 62-year-old man noticed difficulty shooting his rifle when looking through the mount with his left eye (OS) 1 week ago. Over the next few days he observed floaters and paracentral scotomas OS. Since then he has been testing his vision and noticed that similar changes have occurred in the right eye (OD). He had no history of systemic illness and was otherwise in good health.

Exam
OD OS
Visual acuity 20/23 20/84
Intraocular pressure (IOP) (mm Hg) 10 11
Sclera/conjunctiva Clear. No injection Clear. No injection
Cornea Rare nongranulomatous (NG) keratic precipitates (KPs) Rare NG KPs
Anterior chamber (AC) 1+ cell, trace flare 1+ cell, trace flare
Iris Normal Normal
Lens Clear Clear
Vitreous cavity Trace vitreous cells Trace vitreous cells
Retina/optic nerve Similar to OS See Fig. 35.1 . Creamy white lesions in outer retina <{1/2} disc area extending to periphery, with more than 50 lesions throughout the fundus

Fig. 35.1, Creamy white spots in outer retina, <{1/2} disc area, in posterior pole, OS.

Questions to Ask

  • Have you had acute visual loss in either eye before?

  • Have you experienced a flulike illness with malaise, lethargy, or tiredness?

  • Have you been diagnosed with a blood or bone marrow disorder in the past?

  • Are you being treated for any systemic disease affecting other organs?

The patient denies a previous history of acute visual loss, as well as any prodromal illness. He recently underwent a complete annual examination and is in good health with normal complete blood count (CBC) and urinalysis.

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