Journal List > J Korean Ophthalmol Soc > v.59(9) > 1101026

Kim, Choi, and Kim: Bilateral Frosted Branch Angiitis in Kikuchi-Fujimoto Disease

Abstract

Purpose

A case of frosted branch angiitis in Kikuchi-Fujimoto disease is reported.

Case summary

A 33-year-old male complained of a sudden decrease in visual acuity that developed in both eyes 5 days prior. He suffered from a headache, chills, myalgia, and flank pain 1 week before. The initial best-corrected visual acuity (BCVA) was 0.1 in the right eye and 0.2 in the left eye. On slit lamp examination, no inflammatory finding was observed in the anterior chamber and vitreous body of both eyes. On fundus examination, a diffuse vascular sheathing-like frosted branch was found in the retinal vessels, and retinal hemorrhage was observed. Fluorescein angiography showed staining and leakage of dye along the vascular sheathing. Serological findings were negative, showing no evidence of an autoimmune disease or viral infection. Neck ultrasonography revealed non-tender left cervical lymph node enlargement >1 cm in diameter. Ultrasound-guided fine needle aspiration cytology showed findings compatible with Kikuchi-Fujimoto disease, including necrotic changes and pronounced karyorrhexis, plus histiocyte and lymphocyte infiltration without neutrophils. We started systemic steroid therapy. One month after treatment, the BCVA of both eyes improved to 1.0.

Conclusions

In patients with frosted branch angiitis, systemic disease such as Kikuchi-Fujimoto disease should be considered.

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Figure 1.
Fundus exam at the initial visit. Fundus photograph shows sheathing of retinal vessels and multiple retinal hemorrhages in the right (A) and the left (B) eye. Fundus fluorescein angiography at the initial examination shows dye leakages from the sheathed retinal vessels with normal blood flow in the right (C) and the left (D) eye.
jkos-59-876f1.tif
Figure 2.
Histopathological finding of the cervical lymph node. Numerous phagocytic histiocytes and prominent karyorrhexis are identified (hematoxylin and eosin stain [H&E] stain, ×100).
jkos-59-876f2.tif
Figure 3.
Fundus photographs at 1 month after systemic steroid therapy. Fundus photograph shows almost normal without any sheathing of retinal vessels in the right (A) and the left (B) eye.
jkos-59-876f3.tif
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