Granulomas versus metástasis Dr. Pere Garcia Bru Dra. Olga Garcia Garcia Dr. Rodrigo Parada Dra. Natalia Diaz Hospital Universitari de Bellvitge

Vision loss and metamorphopsia CASE REPORT 56-year-old male Vision loss and metamorphopsia in his left eye for 48 hours No relevant medical history

Fundus retinography V.A. 1.0 V.A. 0.3

Exiteix realçament puntiforme de les multiples lesions amb el contrast (gadolini) el que confereix un aspecte vascular de les lesions (vasculitis) tot i que no es pot descartar una presentació atípica d’una malaltia desmielinitzant.

L.E. OCT

A-OCT

Fluorescein Angiography

ICG

Screening NEGATIVE PPD Serology test Blood test ECA Proteinogram ANA ANCA Tumoral markers Chest RX PET-TC NEGATIVE

1 week later… V.A. 0.3

2 weeks later… V.A. 0.5

3 weeks later… V.A. 0.9

Conclusions - Posterior uveitis and tumoral screening must be performed. - Ophthalmic findings and complementary tests may give some hints in differential diagnosis.