Acute Transient Myopic Shift in a Patient With Fever of Unknown Origin: A Case Report

Young Jang Sun; Joon Lee Hyun; Sun Jung Moon; Young Kim So

doi:10.3341/jkos.2009.50.8.1270

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Sun, Hyun, Moon, and So: Acute Transient Myopic Shift in a Patient With Fever of Unknown Origin: A Case Report

Original Article

J Korean Ophthalmol Soc 2009;50(8):1270-1274.

Published online: 7 September 2009

DOI: https://doi.org/10.3341/jkos.2009.50.8.1270

Acute Transient Myopic Shift in a Patient With Fever of Unknown Origin: A Case Report

Young Jang Sun, MD¹, Joon Lee Hyun, MD¹, Sun Jung Moon, MD^1,,², Young Kim So, MD^1,²

¹Department of Ophthalmology, Soonchunhyang University College of Medicine, Seoul, Korea

²Department of Ophthalmology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea

Address reprint requests to So Young Kim, MD Department of Ophthalmology, College of medicine, Soonchunhyang University #23-20 Bongmyeong-dong, Cheonan 330-721, Korea Tel: 82-41-570-2933, Fax: 82-41-576-2262, E-mail: ophdrkim@schch.ac.kr

Received 1 December 200812 May 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose:

To report a case of acute transient myopic shift in a patient with fever of unknown origin.

Case summary:

A 31-year-old woman without a history of any ophthalmic problems presented with a sudden onset of bilateral blurred vision. She was admitted with the diagnosis of fever of unknown origin (FUO). Ophthalmic examination revealed a visual acuity of 0.06 in the right eye and 0.1 in the left eye. A myopic shift of 3.12 diopters (D) and 2.25D was noted in the right and left eyes, respectively. Retinal folds and choroidal thickening accompanied the myopic shift. On the third day after onset, visual acuity had decreased even more. Myopic shift increased to 4.87D in the right eye and 4.50D in the left eye. At the same time, the depth of the anterior chamber maximally decreased and the thickness of the lens was maximally increased. One week later, the myopic shift was normalized to emmetropia. The depth of the anterior chamber and the thickness of the lens also normalized as the fever subsided.

Keywords: Acute transient myopic shift, Fever of unknown origin

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Figure 1.

The fundus photograph shows retinal folds surrounding the macula.

Figure 2.

Ultrasound B-scan reveals choroidal thickening in both eyes.

Figure 3.

Scheimpflug images of Pentacam (A: Day 3 B: Day 7) reveal the change of the anterior chamber depth.

Table 1.

Changes in the parameters of the eyes using Pentacam

	Right eye			Left eye
	Day 0	Day 3	Day 7	Day 0	Day 3	Day 7
Spherical equivalent (Diopter)	-3.12	-4.87	+0.25	-2.25	-4.50	+0.37
Anterior chamber depth (mm)	2.18	1.99	2.67	2.26	2.06	2.67
Anterior chamber volume (mm³)	85	76	129	89	81	123

Note that the myopic shift is improved with deepening of the anterior chamber and increasing of anterior chamber volume.

Table 2.

Changes in the parameters of the eyes using Ultrasound A-scan

	Right eye		Left eye
	Day 3	Day 7	Day 3	Day 7
Anterior chamber depth (mm)	2.61	2.87	2.55	2.90
Lens thickness (mm)	4.18	4.10	4.66	4.13
Axial length (mm)	21.75	22.75	21.78	22.79

Note narrowing of the anterior chamber, thickening of the crystalline lens and shortening of the axial length of the eyes during myopic phase.

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