Acute idiopathic multifocal hemorrhagic retinal vasculitis with transient profound visual loss.

Abstract

Acute idiopathic multifocal hemorrhagic retinal vasculitis is a rare entity. The diagnosis is based on typical fundus findings following exclusion of other more common conditions with similar features. The authors present a case that outlines their approach to diagnosis and management of a patient with simultaneous bilateral presentation. Retrospective case report. This diagnosis often carries a poor prognosis. However, the reported patient did well, with an improvement in vision from light perception in the right eye and hand motions in the left eye at presentation to 20/60 in the right eye and 20/25 in the left eye at 24-month follow-up. Management included intravitreal ganciclovir, oral corticosteroids, panretinal photocoagulation in both eyes, and vitrectomy in one eye. Patients with acute idiopathic multifocal hemorrhagic choroiditis can exhibit delayed and substantial visual improvement despite initial profound visual loss. The authors discuss this case and review the current understanding of the diagnosis and management of this disease.