| 본문 : Purpose : To report a rare case of bilateral macular infarction as an initial presenting sign of Behcet’s disease(BD).
Case report : A 51-year-old female visited our emergency clinic with blindness of the both eyes for 3 days. Best corrected visual acuity (BCVA) was 4/200 in both eyes. Anterior segments were unremarkable. Posterior segment examination showed bilateral multiple and confluent patches of cotton-wool spots with attenuated smaller arterioles at the macula. Spectral domain optical coherence tomography (SD-OCT) showed localized retina edema with subfoveal fluid in both eyes. Multiple small branches of macular arterioles were occluded in both eyes, with perivascular leakage of some macular arterioles at the late phase in the left eye by fluorescein angiography (FA). In collaborration with rheumatology she was diagnosed with Behcet’s disease. She underwent posterior sub-Tenon’s injections of triamcionolone acetonide(TA) in the left eye. Simultaneously she was given oral prednisolone and immunosuppressive agents. Her BCVA gradually improved to 20/200 in the right eye and 16/200 in the left eye after 10 weeks treatment. There was obviously decreasing macular soft exudates in both eyes, with less perivascular leakage in the left eye from FA.
Conclusions : Bilateral macular infarction is an uncommon ocular presenting sign of BD but most severe complication. Early diagnosis and prompt proper treatment is mandatory to improve the vision of both eyes.
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