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  • Courtesy of André Salgado Araújo Marques, MD, Marta Guedes.
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    Uveitis

    Retinography with both fluorescein and indocyanine green angiography of a patient with sympathetic ophthalmia (right eye). He presented with progressive, long-lasting, visual acuity decrease (20/60) and had a history of cataract surgery complicated by retinal detachment (having been submitted twice to vitreoretinal surgery) in his left eye, which had no light perception. On slit-lamp examination it was evident a granulomatous anterior chamber inflammatory reaction and fundus examination revealed the presence of multiple nodular choroidal lesions, mainly in the posterior pole, some of which already in a atrophic stage (Dalen-Fuchs nodules), together with disc swelling. Angiography confirmed the presence of both active (which are hyperfluorescent due to pooling - representing an exudative process - and hypocianescent in the initial stages, fading away later on) and old, atrophic, lesions (hypo fluorescent due to window defect; on indocyanine green angiography, they persist hypocianescent). These nodular lesions represent the granulomatous infiltrates on the choroid; the choriocapillaris tends to be sparred. He was treated with both systemic corticosteroids and cyclosporin A, but since he had a poor response and there were iatrogenic systemic side effects, he was also treated with an intravitreal corticosteroid implant (Ozurdex). He is still being followed in our clinic.