Case 10

A 30 years old male presenting with bilateral diminution of vision. He had a history of left ear infection 5 months ago for which he received medical treatment untill he had a cerebral vascular occlusion and an increase in his ICT (as described by the patient). He then had an ear surgery to relieve the problem 2 months ago and he has been well ever since except for his vision.
His BCVA is 3/60 OD and CF 80 cm OS.

Fundus photos show extensive retinal hemorrhage occupying the inferior fundus of both eyes, sheathed vessels in the same area (click on the image to enlarge), hard exudates in the inferior maculae, disc pallor more in the right with blurring of its edges.

What do the pictures show? Why the inferior fundus bilateral? What is the likely cause?