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A 42-year-old Caucasian male presented with a 1-week history of blurred vision in his right eye following a flu-like illness. He had been treated for an upper-respiratory-tract infection and 2 days later developed pain and blurring of vision in his right eye. He had no significant past medical, ophthalmic or family history. On examination, his visual acuity was 6/60 OD and 6/4 OS. He had no relative afferent pupillary defect. The anterior chamber was quiet, and the rest of the anterior segment examination was unremarkable. There was no vitritis.
Fundus examination revealed detachment of the sensory retina at the right macula. The optic disc was normal. A differential diagnosis of central serous retinopathy (CSR), Harada syndrome, unilateral acute idiopathic maculopathy, idiopathic choroidal neovasculariation and acute posterior multifocal placoid pigment epitheliopathy (APMPPE) was made.
The patient underwent optical coherence tomography (OCT) and a fundus fluorescein angiogram (FFA). An autoimmune screen and toxoplasma/Lyme/Bartonella/viral serology were reported as normal.
Discuss the OCT and FFA findings (figs 1–3).
What is your diagnosis?
How would you manage this …
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