Unilateral Acute Maculopathy Related to Hand, Foot, and Mouth Disease: OCT and Fluorescein Angiography Findings of a Very Rare Disease

Abstract

Hand, foot, and mouth disease is a contagious enteroviral infection occurring primarily in children and characterized by vesicular palmoplantar eruptions and erosive stomatitis. There are very few cases of unilateral acute idiopathic maculopathy associated with hand, foot, and mouth infection. We described a case with unilateral outer retinitis occurring a few days after the onset of disease. A 30-year-old man with reduced vision in his right eye underwent complete ophthalmologic examination including fluorescein angiography and spectral optical coherence tomography. Fundus fluorescein angiography demonstrated mottled hyperfluorescence in the early phase and leakage in the late phase. Spectral domain optical coherence tomography revealed subretinal fluid suggesting a serous detachment and also showed mild intraretinal cystic changes. The fluid disappeared in 1 week with some retinal pigment epithelium changes in the center of the macula. Although this disease is a viral infection associated with reversible symptoms, this case suggests that it can resolve with mild visual loss, and the disease should be considered in the differential diagnosis of acute central serous chorioretinopathy.