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Acute positive titers of antibody to coxsackievirus in acute idiopathic maculopathy.

PURPOSE
To describe a case of acute idiopathic maculopathy (AIM) with positive antibody titers indicative of acute infection with coxsackievirus, the suspected etiology of this disorder.


METHODS
A 15-year-old boy presented with acute severe central visual loss in the left eye after a sore throat with pustular lesions. Visual acuity was 20/200, and fundus examination revealed a pigmented plaque at the level of the retinal pigment epithelium with an overlying neurosensory detachment.


RESULTS
Titers of antibody to coxsackievirus, measured by complement fixation testing, were positive for acute infection with coxsackievirus B1. Our treatment recommendation was observation. In a few weeks, visual acuity spontaneously returned to 20/20 as the exudative changes resolved leaving only a bull's eye-type lesion.


CONCLUSION
Determination of titers of antibody to coxsackievirus, as shown by our case, is a useful laboratory test along with careful fundus biomicroscopy and history taking to confirm a clinical suspicion for AIM.