This woman presented with blurred vision. What is A?
A is pointing to a hyperreflective area that is consistent with exudation.
The superficial layers are intact, as are the deeper layers for most of the image. These is a central large cyst and fluid in both the inner and outer nuclear layers. In the inner nuclear layer, there are 2 lesions with hyperreflective rims and inner hyporeflectivity. At the junction of the outer plexiform and the outer nuclear layer there are a series of exudates. Beneath the central cyst, the external limiting membrane and ellipsoid zones are thinned.
This person was diagnosed with Idiopathic Retinitis, Vasculitis, Aneurysms, and Neuroretinitis (IRVAN), a rare condition in which there are multiple arterial macroaneurysms; other features include vasculitis and retinitis.
In a patient with multiple arterial aneurysms, IRVAN is a possibility.
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