Fig. 5

Dual fluorescein-indocyanine green angiography and optical coherence tomography imaging of a 36 year-old woman with systemic lupus erythematosus unresponsive to aggressive immunomodulatory treatment. Early phase fluorescein angiography (FA) shows extensive retinal pigment epithelial changes with window defects in the right (top row, first frame) and the left eye (top row, third frame); and late phase FA shows hyperfluorescence of the optic disc and peripapillary vasculature as well as subretinal staining/pooling (arrows) in the right eye (middle row, first frame) and staining of the optic disc and vessel walls in the left eye (middle row, third frame). Early phase indocyanine green angiography (ICGA) shows dilated and hyperfluorescent choroidal vessels in both the right (top row, second frame) and the left eye (top row, fourth frame); and late phase ICGA shows more numerous and larger hyperfluorescent areas than revealed by FA in the right eye (middle row, second frame) and also scattered hyperfluorescent spots in the left eye (middle row, fourth frame). SD-OCT shows extensive damage to the outer retina with chronic cystoid changes, subretinal hyperreflective material, and retinal pigment epithelium loss and irregularities in both the right (bottom row, left) and the left eye (bottom row, right)