Atypical white dot syndrome with choriocapillaris ischemia in a patient with latent tuberculosis

被引：8
作者：
Khochtali S. [1 ]
Abroug N. [1 ]
Ksiaa I. [1 ]
Zina S. [1 ]
Attia S. [1 ]
Khairallah M. [1 ]
机构：
[1] Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir
来源：
Journal of Ophthalmic Inflammation and Infection | / 8卷 / 1期
关键词：
Fluorescein angiography; Indocyanine green angiography; Optical coherence tomography angiography; White dot syndrome;
D O I：
10.1186/s12348-018-0162-7
中图分类号：
学科分类号：
摘要：
Background: White dot syndromes (WDS) are a group of idiopathic multifocal inflammatory conditions that can be recognized and distinguished by lesion morphology, other specific clinical features, imaging findings, and disease course. Our purpose is to describe an atypical case of WDS with choriocapillaris ischemia shown by multimodal imaging including swept-source OCT angiography (OCTA) in a 30-year-old woman with latent tuberculosis. Findings: At presentation, visual acuity in the left eye was 20/500. Clinical findings included macular granularity, diffuse outer retinal discoloration with satellite yellow-white dots, and disc margin blurring. Fluorescein angiography showed early confluent areas of choroidal hypofluorescence and late perifoveal punctate hyperfluorescence. There was choroidal hypofluorescence in a geographic configuration throughout the indocyanine green angiography sequence. OCTA showed confluent geographic areas of loss of signal in the choriocapillaris. Work-up revealed latent tuberculosis. The patient received corticosteroids and prophylactic anti-tubercular treatment. Nine months later, visual acuity had improved to 20/20, and there were some residual retinal pigment epithelium changes. Conclusion: Atypical WDS associated with choriocapillaris hypoperfusion may show features of multiple evanescent white dot syndrome and acute posterior multifocal placoid pigment epitheliopathy melting together. © 2018, The Author(s).
引用
收藏
相关论文
共 15 条
  • [1] Dunn J.P., Imaging in the white dot syndromes, Int Ophthalmol Clin, 56, 4, pp. 175-201, (2016)
  • [2] Jampol L.M., Sieving P.A., Pugh D., Fishman G.A., Gilbert H., Multiple evanescent white dot syndrome. I. Clinical findings, Arch Ophthalmol, 102, pp. 671-674, (1984)
  • [3] Herbort C.P., Multiple Evanescent White Dot Syndrome (MEWDS), Intraocular Inflammation, pp. 997-1005, (2016)
  • [4] Khurana R.N., Albini T., Dea M.K., Rao N.A., Lim J.I., Atypical presentation of multiple evanescent white dot syndrome involving granular lesions of varying size, Am J Ophthalmol, 139, 5, pp. 935-937, (2005)
  • [5] Luttrull J.K., Marmor M.F., Nanda M., Progressive confluent circumpapillary multiple evanescent white-dot syndrome, Am J Ophthalmol, 128, 3, pp. 378-380, (1999)
  • [6] Barile G.R., Harmon S.A., Multiple evanescent white dot syndrome with central visual loss, Retin Cases Brief Rep, 11 Suppl 1, pp. S219-S225, (2017)
  • [7] Tavallali A., Yannuzzi L.A., MEWDS, common cold of the retina, J Ophthalmic Vis Res, 12, 2, pp. 132-134, (2017)
  • [8] Fiore T., Iaccheri B., Cerquaglia A., Lupidi M., Torroni G., Fruttini D., Cagini C., Outer retinal and choroidal evaluation in multiple evanescent white dot syndrome (MEWDS): an enhanced depth imaging optical coherence tomography study, Ocul Immunol Inflamm, 26, 3, pp. 428-434, (2018)
  • [9] Gaudric A., Mrejen S., Why the dots are black only in the late phase of the indocyanine green angiography in multiple evanescent white dot syndrome, Retin Cases Brief Rep, 11 Suppl 1, pp. S81-S85, (2017)
  • [10] Pichi F., Srvivastava S.K., Chexal S., Et al., En face optical coherence tomography and optical coherence tomography angiography of multiple evanescent white dot syndrome: new insights into pathogenesis, Retina, 36, pp. S178-S188, (2016)
12