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

2. 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

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

4. 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.

5. L.E. OCT

6. A-OCT

7. Fluorescein Angiography

8. ICG

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

10. 1 week later…
V.A. 0.3

11. 2 weeks later…
V.A. 0.5

12. 3 weeks later…
V.A. 0.9

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