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E.P. Tilton, N.G. Ghazi, A. Daccache, B.P. Conway; Acute Idiopathic Maculopathy: Report of a Bilateral Case Manifesting a Macular Hole . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3249.
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To report an unusual case of bilateral acute idiopathic maculopathy which was associated with a macular hole (MH) and elevated coxackievirus titers.
A 30 year old female with bilateral exudative maculopathy and a MH in the left eye was followed up with fundus photography, fluorescein angiography (FA) and optical coherence tomography (OCT). No indocyanine green (ICG) angiography was performed. A possible association with coxackievirus infection was evaluated. Pars plana vitrectomy (PPV) in an attempt to close the MH was also performed.
The clinical presentation and evolution of the maculopathy were most compatible with "unilateral acute idiopathic maculopathy" (UAIM) but with bilateral involvement. The subretinal infiltrates resolved in both eyes with full recovery of vision in the right eye. In the left eye, the MH persisted despite resolution of the exudative process. PPV failed to seal the hole. The patient was found to have elevated coxackievirus titers at presentation. Some atypical angiographic features of the reported case were emphasized as they may shed light on the pathogenesis of the maculopathy.
We report a case of "UAIM" with bilateral involvement, a MH in one eye, and elevated coxackievirus titers. To our knowledge, a MH, which further expands the clinical spectrum of this maculopathy process, has not been previously described.
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