title: Unilateral subretinal fibrosis and uveitis syndrome.
abstract: Subretinal fibrosis and uveitis syndrome is a rare, potentially devastating, posterior uveitis of unknown aetiology, characterised bilaterally by initial multifocal choroiditis with later progressive subretinal fibrosis. We report a rare case of unilateral subretinal fibrosis and uveitis syndrome. To date, there are only two case reports of unilateral disease. Our patient presented with unilateral blur and was found to have reduced visual acuity. A Bartonella profile was positive and a diagnosis of Bartonella posterior uveitis was made. Several positive ocular findings in the anterior chamber and on fundoscopy consistent with the syndrome were found. When steroid therapy alone could no longer control active inflammation, the immunosuppressive agent mycophenolate was added. Over time subretinal fibrosis became established sparing the macula and associated complications occurred, but with mycophenolate, at four years, our patient's visual acuity had improved and remains stable. Moreover, four years after her initial presentation, her condition remains strictly unilateral.
authors.affiliation: Fourth Year Medical Student, Cardiff University, UK.
authors.forename: S
authors.initials: S
authors.lastname: Rehan
authors.affiliation: Fourth Year Medical Student, Cardiff University, UK.
authors.forename: Z
authors.initials: Z
authors.lastname: Javaid
authors.affiliation: Consultant Medical Ophthalmologist and Honorary Lecturer, Cardiff Eye Unit, University Hospital of Wales, UK ayadberman@hotmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Al-Bermani
mesh_terms: D000293:Adolescent; D001474:Bartonella Infections / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D005355:Fibrosis; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012160:Retina; D013577:Syndrome; D016896:Treatment Outcome; D014605:Uveitis / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D014792:Visual Acuity / Q000187:drug effects*
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid
keywords: Bartonella; Subretinal fibrosis and uveitis syndrome; autoimmune; retinal pigment epithelium; unilateral