Retinal cases & brief reports · 2025
BILATERAL UVEITIS, RETINAL PERIPHLEBITIS, AND OPTIC NEURITIS ASSOCIATED WITH NON-PINEAL CENTRAL NERVOUS SYSTEM GERMINOMA.
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Liu Tianyu, Chebolu Apoorv P, Chung Caroline W, Kruszewski Adam M, Bhatt Nirali, Brucker Alexander J
Аннотация
PURPOSE: The aim of this study was to report a case of bilateral uveitis, retinal periphlebitis, and optic neuritis associated with a non-pineal central nervous system germinoma.
METHODS: This is a case report.
RESULTS: A 32-year-old man presented with episodes of acute painless visual disturbance in each eye and was found to have decreased VA, abnormal color vision, an afferent pupillary defect in the left eye, bilateral optic disc edema, perivenous sheathing, and candle-wax dripping exudates. Optical coherence tomography revealed bilateral intraretinal fluid and posterior vitreous hyperreflective opacities. Fluorescein angiography revealed bilateral optic disc leakage without active small vessel leakage. Magnetic resonance imaging of the brain and orbits revealed enhancing periventricular lesions and enhancement of the left optic nerve and bilateral perioptic nerve sheaths, posterior globes, and optic nerve heads. Brain biopsy was consistent with a central nervous system germinoma. His ocular signs and symptoms improved with chemotherapy for the germinoma.
CONCLUSION: Central nervous system germinomas, including those located outside the pineal region, can be associated with optic neuritis, uveitis, and periphlebitis including characteristic candle-wax dripping exudates. Ocular signs and symptoms typically improve with treatment of the underlying germinoma.
METHODS: This is a case report.
RESULTS: A 32-year-old man presented with episodes of acute painless visual disturbance in each eye and was found to have decreased VA, abnormal color vision, an afferent pupillary defect in the left eye, bilateral optic disc edema, perivenous sheathing, and candle-wax dripping exudates. Optical coherence tomography revealed bilateral intraretinal fluid and posterior vitreous hyperreflective opacities. Fluorescein angiography revealed bilateral optic disc leakage without active small vessel leakage. Magnetic resonance imaging of the brain and orbits revealed enhancing periventricular lesions and enhancement of the left optic nerve and bilateral perioptic nerve sheaths, posterior globes, and optic nerve heads. Brain biopsy was consistent with a central nervous system germinoma. His ocular signs and symptoms improved with chemotherapy for the germinoma.
CONCLUSION: Central nervous system germinomas, including those located outside the pineal region, can be associated with optic neuritis, uveitis, and periphlebitis including characteristic candle-wax dripping exudates. Ocular signs and symptoms typically improve with treatment of the underlying germinoma.