Presumed non-inflammatory bilateral peripapillary subretinal fibrosis in adolescent patients.
Selda Celik Dulger, Mehmet Yasin Teke
✦ AI-curated · Sources linked
Case in brief
Two adolescents presented with bilateral peripapillary subretinal fibrotic lesions and no overt clinical or angiographic evidence of active intraocular inflammation. Imaging showed variable macular involvement: one eye had macular extension with OCT cystic changes and findings suggestive of subfoveal choroidal neovascularization; another had marked outer retinal atrophy and increased choroidal hypertransmission. Fluorescein angiography showed late staining of fibrosis and window-defect hyperfluorescence in atrophic areas. Reduced visual acuity occurred only in eyes with macular involvement. The cases were considered presumed non-inflammatory, although inherited retinal disease or subclinical inflammation or infection could not be excluded.
What made this case unusual
Bilateral peripapillary fibrosis occurred in adolescents without overt inflammatory signs, despite variable macular extension, atrophy, and findings suggestive of subfoveal choroidal neovascularization.
Diagnostic / clinical pearl
Peripapillary subretinal fibrosis without evident active inflammation does not establish a non-inflammatory cause; inherited retinal disease and subclinical inflammatory or infectious disease may remain possible.