Acquired focal choroidal excavation associated with multiple evanescent white dot syndrome: observations at onset and a pathogenic hypothesis

详细信息    查看全文

• 作者：Yuki Hashimoto ; Wataru Saito ; Kousuke Noda ; Susumu Ishida
• 关键词：Choroidal thickness ; Enhanced depth imaging optical coherence tomography ; Focal choroidal excavation ; Multiple evanescent white dot syndrome
• 刊名：BMC Ophthalmology
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：14
• 期：1
• 全文大小：1,052 KB
• 参考文献：1. Jampol, LM, Sieving, PA, Pugh, D, Fishman, GA, Gilbert, H (1984) Multiple evanescent white dot syndrome. I. Clinical findings. Arch Ophthalmol 102: pp. 671-674 CrossRef
  2. Li, D, Kishi, S (2009) Restored photoreceptor outer segment damage in multiple evanescent white dot syndrome. Ophthalmology 116: pp. 762-770 CrossRef
  3. Ie, D, Glaser, BM, Murphy, RP, Gordon, LW, Sjaarda, RN, Thompson, JT (1994) Indocyanine green angiography in multiple evanescent white dot syndrome. Am J Ophthalmol 117: pp. 7-12 CrossRef
  4. Aoyagi, R, Hayashi, T, Masai, A, Mitooka, K, Gekka, T, Kozaki, K, Tsuneoka, H (2012) Subfoveal thickness in multiple evanescent white dot syndrome. Clin Exp Optom 95: pp. 212-217 CrossRef
  5. Jampol, LM, Shankle, J, Schroeder, R, Tornambe, P, Spaide, RF, Hee, MR (2006) Diagnostic and therapeutic challenges. Retina 26: pp. 1072-1076 CrossRef
  6. Margolis, R, Mukkamala, SK, Jampol, LM, Spaide, RF, Ober, MD, Sorenson, JA, Sherman, J, Freund, KB (2011) The expanded spectrum of focal choroidal excavation. Arch Ophthalmol 129: pp. 1320-1325 CrossRef
  7. Ellabban, AA, Tsujikawa, A, Ooto, S, Yamashiro, K, Oishi, A, Nakata, I, Miyake, M, Akagi-Kurashige, Y, Ueda-Arakawa, N, Arichika, S, Yoshitake, S, Takahashi, A, Yoshimura, N (2013) Focal choroidal excavation in eyes with central serous chorioretinopathy. Am J Ophthalmol 156: pp. 673-683 CrossRef
  8. Lee, CS, Woo, SJ, Kim, YK, Hwang, DJ, Kamg, HM, Kim, H, Lee, SC (2014) Clinical and spectral-domain optical coherence tomography findings in patients with focal choroidal excavation. Ophthalmology 121: pp. 1029-1035 CrossRef
  9. Guyer, DR, Schachat, AP, Green, WR The choroid: Structural considerations. In: Ryan, SJ eds. (2006) RETINA. Mosby, Los Angeles, pp. 39-41
  10. The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1471-2415/14/135/prepub
  
• 刊物主题：Ophthalmology;
• 出版者：BioMed Central
• ISSN：1471-2415

文摘

Background The mechanism underlying focal choroidal excavation (FCE) remains largely unknown. We evaluated the sequential progression of FCE generation using enhanced depth imaging optical coherence tomography (EDI-OCT) in a patient with multiple evanescent white dot syndrome (MEWDS). Case presentation A 37-year-old woman suffered MEWDS in the right eye. EDI-OCT showed the loss of photoreceptor inner segment/outer segment junction line, detachment between the retinal pigment epithelium (RPE) and Bruch’s membrane, and dome-shaped, moderately reflective, focal photoreceptor-layer lesions corresponding to perifoveal white dots. The region with pigment epithelium detachment involved RPE/Bruch’s membrane ruptures. After 1?month, almost all white dots spontaneously resolved together with improvements of the perifoveal OCT findings. Interestingly, perifoveal region developed a conforming-type FCE. An abnormal hyper-reflective lesion on OCT, regarded as fibrosis formation, simultaneously appeared within the choroid below the FCE and subsequently increased in size. Conclusions These results suggest that the RPE/Bruch’s membrane disruption due to chorioretinal abnormalities and subsequent intrachoroidal scar formation play a role in the pathogenesis on an acquired FCE.