This 19yo presented with counting fingers (CF) vision OD and 20/20 OS.
There is a frosted appearance to the superior retinal veins with surrounding retinal hemorrhages. Fluorescein angiography (FA) shows some vascular staining and optic nerve leakage.
The patient was started on oral steroids, and one week later, the fundus findings had improved significantly (not pictured). Bloodwork came back negative.
Learning Points:
Frosted branch angiitis is a retinal vasculitis that gets its name due to the involved vessels resembling the branches of a tree that are “frosted” with snow.
Although these findings may be isolated, they are often considered a phenotype found in a multitude of inflammatory conditions, most commonly CMV retinitis.
The inflammation is usually highly responsive to steroids, and the visual prognosis is generally good, although some patients may develop secondary neovascularization in the anterior and posterior segments due to widespread ischemia.
