Early recognition and systemic management of retinal vasculitis in a 15-year-old male

Retinal vasculitis is an inflammatory disorder of the retinal vasculature with diverse etiologies. This case is reported for its relatively uncommon age and distinctive signs, emphasizing the identification of subclinical involvement and the efficacy of early systemic intervention. A 15-year-old male presented with a two-week history of right-eye floaters, 0.00 LogMAR visual acuity bilaterally, and normal anterior segments, without other symptoms. Fundus examination of the right eye revealed inferior small patchy hemorrhages. Fluorescein angiography revealed early venous tortuosity and a mass-like hyperfluorescent lesion in the right superior retina, with late optic disc hyperfluorescence, segmental vascular staining, and significant dye leakage, while the left eye showed mild segmental vascular staining and slight late leakage. Comprehensive laboratory workup was negative for active infection and systemic autoimmune disease. A diagnosis of isolated retinal vasculitis was therefore favored. Systemic intravenous corticosteroids were initiated on admission, followed by oral corticosteroids after discharge. The floaters and hemorrhages resolved progressively, and by the 2-week outpatient follow-up, all clinical signs had completely resolved, with preserved visual acuity. Retinal vasculitis in adolescents may present with monosymptomatic manifestations such as floaters at an early age before twenty. After excluding systemic disease, prompt systemic corticosteroid therapy achieved favorable visual preservation.