Analysis of progressive ophthalmic lesion in a patient with subacute sclerosing panencephalitis.

PURPOSE To evaluate the progressive lesions affecting the visual system in a patient with subacute sclerosing panencephalitis (SSPE). METHODS The authors observed a 15-year-old boy with SSPE. Since the diagnosis was made before the appearance of ocular manifestations, the authors recorded the progressive ocular lesions using various ophthalmic examinations. RESULTS The patient showed no ophthalmic abnormalities until he developed a left homonymous hemianopia with sudden bilateral disturbed visual acuity. Severe progressive macular lesions including a pigment epithelial window defect by fluorescein angiography, a marked decrease in foveal thickness by optical coherence tomography, and an extensive disorder mainly specific to cone cells in the central retina by electroretinography were demonstrated. Novel findings such as a transient relative afferent pupillary defect and an anterior uveitis were also observed. CONCLUSIONS Analyses over a long period of time showed progressive ophthalmic findings in a patient with SSPE.