Courtesy of Ryan Shields MD, Tarek Hassan MD.
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Retina/Vitreous, Uveitis
Wide angle fundus photographs demonstrating subtle mid-peripheral small yellow/white choroidal infiltrates in both eyes. This patient presented with progressive, painless, left-sided monocular vision loss and elevated Angiotensin Converting Enzyme (ACE) and Lysozyme levels. MRI of the brain and orbit demonstrated a mildly enlarged left pre-chiasmatic optic nerve with T2 enhancement and innumerable scattered foci of T2 and FLAIR hyper-intensities in the subcortical white matter in both hemispheres.