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

BMC Ophthalmology

Case Report

Yuki Hashimoto¹  Susumu Ishida²  Wataru Saito²  Kousuke Noda² 

[1] Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan;Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan;Department of Ocular Circulation and Metabolism, Hokkaido University Graduate School of Medicine, Nishi 7, Kita 15, 060-8638, Sapporo, Kita-ku, Japan;

关键词: Choroidal thickness;    Enhanced depth imaging optical coherence tomography;    Focal choroidal excavation;    Multiple evanescent white dot syndrome;   

DOI  :  10.1186/1471-2415-14-135

 received in 2014-07-02, accepted in 2014-11-13,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundThe 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 presentationA 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.ConclusionsThese 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.

【 授权许可】

Unknown   
© Hashimoto et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.