Multi-Modal Imaging in Diffuse Subretinal Fibrosis With Uveitis Syndrome

Purpose To describe clinical features including multimodal imaging in a case of diffuse subretinal fibrosis and uveitis syndrome. Methods A young patient presented with counting fingers in both eyes (OU) due to posterior uveitis and unresponsive to systemic corticosteroids. Ultra-wide field (UWF) pseudo-color and autofluorescence (FAF) imaging, optical coherence tomography angiography En-face, optical coherence tomography angiography (OCT-A) and spectral-domain optical coherence (SD-OCT) were performed. Results Clinical examination revealed a bilateral fibrosis plaque in both fovea and macular multifocal choroidal lesions associated, with no vitritis. UWF-FAF allowed us to determine activity showing a hyperfluorescent pattern. En-face OCT-A at the level of the ellipsoid layer showed multiple hyperreflective lesions surrounding an hyperreflective fibrosis plaque in OU, which improved and stabilized during the follow-up. OCT-A at the level of RPE-choriocapillaris revealed neocapillary network changes along the chronification of the disease. The patient required the addition of intravitreal dexamethasone implants (ozurdex®) to control the acute rebounds and anti-TNF? to control the underlying inflammatory process. Conclusions This is the first Diffuse Subretinal Fibrosis with Uveitis syndrome reported with a complete En-face OCT-A and OCT-A examination. This multi-modal imaging will improve the monitoring of the disease's activity and the chronicity changes.