title: Multimodal imaging in a case of bilateral outer retinitis associated with mumps infection.
abstract: OBJECTIVE
  To report the results of multimodal imaging of acute outer retinitis associated to mumps infection.
  
  
  METHODS
  A patient with mumps-associated outer retinitis evaluated by color fundus photography, spectral domain optical coherence tomography (SD-OCT), optical coherence tomography angiography, fundus autofluorescence (FAF), fluorescein angiography (FA), and indocyanine green angiography (ICGA).
  
  
  RESULTS
  We report a case of a 12-year-old boy who developed bilateral outer retinitis related to mumps. Ophthalmoscopy showed confluent areas of outer retinitis involving the posterior pole and the periphery with a centrifugal gyrate pattern. SD-OCT revealed a marked disorganization of the outer retinal layers with multiple highly reflective spicules. FA shows diffuse late hyperfluorescence with optic disk staining. ICGA shows macular and peripheral hyperfluorescent lesions with a geographical pattern in the late phases. The patient was treated with acyclovir and oral prednisone. Four weeks after presentation visual acuity remained unchanged, and retinal changes seen at the acute phase had resolved leading to extensive retinal atrophy and optic disk pallor. SD-OCT showed atrophy of the retinal pigment epithelial and outer retinal layers. FAF revealed scattered hyperautofluorescent lesions. Electrophysiology showed generalized retinal dysfunction.
  
  
  CONCLUSIONS
  Mumps infection should be considered in the differential diagnosis of bilateral necrotizing outer retinitis in children and young adults. A multimodal imaging approach may help distinguish mumps-associated retinitis from other causes of viral retinitis and facilitate appropriate management.
authors.affiliation: Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, 5019, Monastir, Tunisia.
authors.forename: Rim
authors.initials: R
authors.lastname: Kahloun
authors.affiliation: Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, 5019, Monastir, Tunisia.
authors.forename: Hager
authors.initials: H
authors.lastname: Ben Amor
authors.affiliation: Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, 5019, Monastir, Tunisia.
authors.forename: Imen
authors.initials: I
authors.lastname: Ksiaa
authors.affiliation: Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, 5019, Monastir, Tunisia.
authors.forename: Sourour
authors.initials: S
authors.lastname: Zina
authors.affiliation: Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, 5019, Monastir, Tunisia.
authors.forename: Bechir
authors.initials: B
authors.lastname: Jelliti
authors.affiliation: Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, 5019, Monastir, Tunisia.
authors.forename: Salim
authors.initials: S
authors.lastname: Ben Yahia
authors.affiliation: Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, 5019, Monastir, Tunisia. moncef.khairallah@rns.tn.
authors.forename: Moncef
authors.initials: M
authors.lastname: Khairallah
mesh_terms: D002648:Child; D003937:Diagnosis, Differential; D015828:Eye Infections, Viral / Q000175:diagnosis* / Q000821:virology; D005451:Fluorescein Angiography / Q000379:methods*; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D064847:Multimodal Imaging / Q000379:methods*; D009107:Mumps / Q000150:complications* / Q000175:diagnosis; D009887:Ophthalmoscopy; D012160:Retina / Q000000981:diagnostic imaging*; D012173:Retinitis / Q000175:diagnosis* / Q000209:etiology / Q000821:virology; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity
keywords: Fluorescein angiography; Fundus autofluorescence; Indocyanine green angiography; Multimodal imaging; Mumps; Optical coherence tomography; Outer retinitis