Stepwise approach for fundus imaging in the diagnosis and management of posterior uveitis

Pachychoroid Associated With Acute Retinal Necrosis Secondary to Varicella Zoster Virus

“…Previously, the presence of pachychoroid could errone ously lead providers toward the diagnosis of toxoplasmosis or other pathologies that preferentially involve the choroid with subsequent retinal involvement, including fungal or bacterial infections. 3 Typically, the clinical context and fundoscopic appearance can differentiate these etiologies. In cases of immunosuppression or atypical presentations, OCT findings are helpful in establishing the diagnosis.…”

“…OCT is thought to be helpful in distinguishing viral ARN from other nonviral causes of retinitis, such as toxoplasmosis, because ARN was thought to spare the choroid, whereas focal thickening of the choroid is highly suggestive of toxoplasmosis. 3 We performed a retrospective chart review of a patient with VZVrelated, PCRconfirmed ARN that resulted in typical OCT characteristics of fullthickness retinal hyperreflectivity, vitritis, and SRF and also showed a new finding-choroidal thickening underlying the area of retinal involvement. Further more, the choroidal thickening resolved after treatment with antivirals and steroids.…”

“…OCT is thought to be helpful in distinguishing viral ARN from other nonviral causes of retinitis, such as toxoplasmosis, because ARN was thought to spare the choroid, whereas focal thickening of the choroid is highly suggestive of toxoplasmosis. 3…”