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Abstract
Purpose
To report a case of relapsing polychondritis complicated with chorioretinitis without scleritis.
Case summary
A 35-year-old man who has been previously managed for relapsing polychondritis visited our the clinic because of blurred vision in his both eyes which had developed one month earlier. Although the corrected visual acuity was 1.0 in both eyes, Slit lamp examination of both eyes showed findings of anterior uveitis. Fundus examination showed a whitish-yellow lesion around the posterior pole in both eyes. He had bilateral auricular chondritis, saddle nose deformity, and respiratory difficult. The patient was treated with systemic steroid and prescribed topical 1% prednisolone acetate four times daily in both eyes. Four months later, fundus examination of both eyes showed improvement of chorioretinal lesion, but visual acuity had decreased constantly. Nine months later, chorioretinal lesion resolved and visual acuity improved in both eyes.
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Figure 1.
(A) Photographs of both external ears show auricular cartilage deformity. (B) The photograph of nose shows saddle nose deformity resulting from loss of nasal cartilage. (C) Photomicrograph of biopsy specimen from the ear. Degenerating changes in the marginal cartilage and mononuclear inflammatory cells and fibroblasts are seen replacing the destroyed cartilage from the edge of cartilaginous plate (hematoxylin-eosin, *200). (D) Head and neck CT reveals narrowing of the trachea.
Figure 2.
Fundus photographs show two 1 disc diameter-sized whitish yellow retinal infiltrates temporal and inferior to the macula, respectively in the right eye (A), and 2 disc diameter-sized whitish yellow retinal infiltrate temporal to the macula in the left eye (B). The horizontal OCT image showed detachment of the neurosensory retina nasally and temporally in the right eye (C), and shallow detachment of the neurosensory retina and focal RPE detachment nasally in the left eye (D). The early phase fluorescein angiogram showed blockage of choroidal fluorescence on retinal infiltrates in the right (E) and left (F) eyes. The late phase fluorescein angiogram showed hyperfluorescence caused by leakage from the choroid in the right (G) and left (H) eyes.
Figure 3.
B-scan ultrasonograms showed no thickening of the choroid and sclera in the right (A) and left (B) eye.
Figure 4.
The horizontal OCT image 7 weeks later showed that the RPE detachment appears slightly worse than on the previous exam in the left eye.
Figure 5.
(A) The horizontal OCT image 3 months later showed improvement of detachment of the neurosensory retina and RPE detachment in the left eye. Early (B) and late (D) phase fluorescein angiograms 3 months later remain unchanged in the right eye. Blockage of choroidal fluorescence in the early phase (C) and hyperfluorescence caused by leakage from the choroid in the late phase (E) in the left eye appear worse than on the previous examination.
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