Unilateral acute maculopathy associated with adult onset hand, foot and mouth disease: case report and review of literature

Abstract

BackgroundAcute maculopathy is a rare condition of unknown aetiology and Coxsackie virus is known to be associated with this macular chorioretinitis.FindingsWe report a case of acute unilateral maculopathy in a 35-year-old woman with concurrent hand foot and mouth disease. Furthermore, we display multimodal imaging (colour fundus photographs, autofluorescence, spectral domain ocular coherence tomography, fluorescein angiography and indocyanine green angiography) charting the course of the disease. The source of the virus was thought to be the patient's child. Empirical treatment with oral corticosteroids was commenced and the inflammation resolved, leaving a residual macular scar.ConclusionsWe present this case combined with the review of literature of adult onset Coxsackie-virus-associated retinitis. This case reiterates the fact that Coxsackie virus is an uncommon but important consideration in the differential diagnosis of chorioretinitis and posterior uveitis with atypical retinopathy.

Unilateral hemorrhagic maculopathy: An uncommon manifestation of hand, foot, and mouth disease

“…[48] Two reports on the use of steroids in HFD have been described previously. [910] In this case, we used steroids, and the patient had anatomical and functional normalization within 2 months which goes in conjunction with the previous reports of steroid usage, and the recovery was faster. The difference between this case and a previous case[9] where steroids were used is that in our case, there was complete recovery of retinal architecture as shown by normalization of OCT and reformation of IS/OS junction.…”

A literature review and case report of hand, foot and mouth disease in an immunocompetent adult

“…A study in Japan suggests the possibility that the HFMD could also cause opsoclonus-myoclonus (jerky eye movements in all directions) as a possible viral or autoimmune response [ 15 ], other studies reports cases of retinopathy and vision loss in this entity [ 16 ].…”

Central serous retinopathy and hand–foot–mouth disease: coincidence or causation?

“… 19 The ocular morphology represented by these cases included chorioretinitis, vasculitis, exudates, macular detachment, retinitis, retinal detachment, and discoloration of the macula. 19 …”

“…Similarly, in 2015, a 35-year-old female presented with acute maculopathy with concurrent HFMD infection. 19 This patient had characteristic dermatological symptoms of HFMD and had been in contact with the virus from her daughter. 19 Agrawal et al produced results from a systematic review of ocular associations of HFMD worldwide and identified 11 previous cases with a mean age of 33 years and only two occurring in females.…”

“… 19 Agrawal et al produced results from a systematic review of ocular associations of HFMD worldwide and identified 11 previous cases with a mean age of 33 years and only two occurring in females. 19 The ocular morphology represented by these cases included chorioretinitis, vasculitis, exudates, macular detachment, retinitis, retinal detachment, and discoloration of the macula. 19 …”