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Colour fundus photographs showing bilateral multiple cream coloured deep retinal placoid lesions. The right fovea is involved.

Case 29

Figure 1. Colour fundus photographs showing bilateral multiple cream coloured deep retinal placoid lesions. The right fovea is involved.

Author: Simon Nothling     Editor: Adrian Fung

A 24-year-old female engineer presented with a 1 week history of bilateral blurred vision with paracentral scotomas and occasional flashes.

Case history

A 24-year-old female engineer presented with a 1 week history of bilateral blurred vision with paracentral scotomas and occasional photopsiae. She was a low myope, but had no other ophthalmic history. Two months prior she had suffered from a severe viral upper respiratory tract infection. There were no neurological symptoms such as limb weakness, speech disturbance or headaches. She had no past medical history, and was not on regular medication. There was no recent overseas travel.

On examination, best corrected visual acuities were 6/7.5-2 right eye (OD) and 6/5 left eye (OS). Intraocular pressures were 8mmHg (OD) and 9mmHg (OS). There was 1+ white blood cells in both anterior chambers, but no vitritis. Dilated fundoscopy showed multiple cream coloured deep retinal placoid lesions involving both maculae (Figure 1). The right macula had larger lesions, with the superior lesion involving the fovea. The lesions appeared to be of different ages as some had scattered pigmentary changes. There was no disc swelling or vasculitis in either eye.

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