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

作者：Hashimoto Yuki; Saito Wataru^*; Noda Kousuke; Ishida Susumu

来源：BMC Ophthalmology, 2014, 14(1): 135.

DOI：10.1186/1471-2415-14-135

• Choroidal thickness
• Enhanced depth imaging optical coherence tomography
• Focal choroidal excavation
• Multiple evanescent white dot syndrome

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). %26lt;br%26gt;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%26apos;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%26apos;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. %26lt;br%26gt;Conclusions: These results suggest that the RPE/Bruch%26apos;s membrane disruption due to chorioretinal abnormalities and subsequent intrachoroidal scar formation play a role in the pathogenesis on an acquired FCE.

• 出版日期2014-11-20