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A 37-year-old man with a black spot in his vision
Digital Journal of Ophthalmology 2010
Volume 16, Number 1
February 9, 2010
DOI: 10.5693/djo.03.2009.12.001
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Ann-Marie Lobo, MD | Massachusetts Eye & Ear Infirmary and Harvard Medical School
George N. Papaliodis, MD | Massachusetts Eye and Ear Infirmary, Massachusetts General Hospital, and Harvard Medical School
Treatment
During the patient’s multiple hospital courses, he achieved improvement in his neurologic symptoms with intravenous methylprednisolone; however, when he was discharged on oral prednisone his symptoms recurred. Given the worsening of the patient’s retinal vasculitis, it was recommended that the patient receive an extended course of intravenous methylprednisolone. At the same time, the patient also received induction with four doses of intravenous cyclophosphamide.

One week after this treatment was instituted, the patient’s visual acuity was stable, and the retinal vasculitis had markedly improved on fluorescein angiography.
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Figure 6
Fluorescein angiography 1 week after initiating therapy with Solumedrol and cyclophosphamide with significant improvement in areas of vasculitis