The aqueous phase of neuroretinitis as a diagnostic challenge

A 25-year-old man attended our office due to vision loss, metamorphopsia, headache, malaise, and fatigue. Visual acuity was 20/80 on the right eye and 20/20 on the left eye. On fundoscopy of the right eye, the optic nerve head (ONH) was elevated temporarily with the appearance of subretinal fluid from the ONH to the center of the macula. Since 1916, this entity has been studied, in the beginning, as “stellate maculopathy” by Theodor Leber until Donald Gass proved the origin of the fluid from the optic nerve vasculature, changing the nomenclature to neuroretinitis in 1977. The diagnosis of Neuroretinitis is challenging, specifically in the aqueous phase that can be confused by other macular entities. In this case, we present a patient with clinical and tomographic images in both aqueous and exudate phases with an interval of 3 weeks, intended to be representative of the pathological stages of neuroretinitis.