A twelve-year-old boy presented with complaining of sudden visual loss in both eyes. His past medical history revealed a chickenpox infection 20 days prior to presentation. Visual acuity was 20/800 in each eye. External exam was unremarkable. Slit lamp exam of the anterior segment showed no KPs with 1+ anterior chamber cells in left eye. Dilated fundus examination revealed diffuse vascular sheathing in veins bilaterally.
OCT demonstrated corresponding macular edema with serous retinal detachment.
Fundus fluorescein angiography showed optic disc hyperfluorescence, venous staining, increased tortuosity and mild leakage which were prominent in the left eye.
Patient was considered as frosted branch angiitis associated with chickenpox infection.
The clinical presentation of frosted branch angiitis does not correlate with any single etiology. It is a rare entity that has a broad differential diagnosis including noninfectious and infectious etiologies such as leukemia -lymphoma, auto-immune conditions, herpes simplex virus, varicella zoster virus, and toxoplasmosis.
Credit: Merve İnanç Tekin, MD, FEBO
Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
Instagram accounts: @uveacademy and @merveinanctekin