A review of unilateral acute idiopatic maculopathy related to hand-foot-mouth disease with a representative case.
The purpose of this study was to review unilateral acute maculopathy associated with hand-foot-mouth disease with a representative case. Clinical course of a 24-year-old male case with unilateral acute idiopatic maculopathy documented by multimodal imaging is presented, and a review of similar cases is given. On initial examination, best-corrected visual acuity was 20/200 in the left eye. Fundoscopy revealed grayish-yellowish subretinal exudate, and fluorescein angiography demonstrated irregular mottled hyperfluorescence at the central macula. Spectral domain optical coherence tomography demonstrated disruption of ellipsoid layer, which partially resolved on follow-up examinations. Best-corrected visual acuity increased to 20/20 at 3 months, with persistent retinal changes, and mild disruption of ellipsoid layer and persistent mild metamorphopsia. Although hand-foot-mouth disease is usually benign and self-limited in childhood, it may be rarely associated with unilateral vision loss due to maculopathy, especially at early adulthood in both sexes. Vision loss associated with this eruption is acute and reversible in most cases, despite some residual pigmentary and scarring changes in all cases and persistent mild visual loss in some cases. Exact pathophysiology, the causes of variability of clinical features, adulthood onset, unilateral involvement, and role of multimodal imaging are issues which need to be clarified with further research.
Department of Ophthalmology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey. resatduman@gmail.com.
Reşat
R
Duman
Department of Dermatology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
Nilay
N
Duman
Department of Ophthalmology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
Bünyamin
B
Kutluksaman
Department of Ophthalmology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
Ersan
E
Çetinkaya
Department of Ophthalmology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
Sibel
S
İnan
Department of Ophthalmology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
Ümit Übeyt
ÜÜ
İnan
D015828:Eye Infections, Viral / Q000150:complications*; D006232:Hand, Foot and Mouth Disease / Q000150:complications*; D006801:Humans; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D012164:Retinal Diseases / Q000821:virology*; D014786:Vision Disorders / Q000821:virology; D055815:Young Adult
Acute maculopathy; Hand–foot–mouth disease; Unilateral vision loss; Viral eruption