IDIOPATHIC MULTIFOCAL CHOROIDITIS PRESENTING WITH A TRANSIENT PERIPAPILLARY WHITE RING
| Autor: | Rosa Dolz-Marco, Quraish Ghadiali, Sarra Gattoussi, K. Bailey Freund |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty Choroiditis Visual acuity genetic structures Lesion 03 medical and health sciences 0302 clinical medicine Optical coherence tomography Ophthalmology medicine Humans Medical history medicine.diagnostic_test business.industry Blind spot Multifocal Choroiditis Retinal Degeneration General Medicine Retinal Photoreceptor Cell Outer Segment medicine.disease Fluorescein angiography eye diseases Lattice degeneration 030221 ophthalmology & optometry Optic nerve Female sense organs medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | RETINAL Cases & Brief Reports. 12:S81-S86 |
| ISSN: | 1935-1089 |
| Popis: | Purpose We describe with multimodal imaging the presentation and follow-up for a patient with idiopathic multifocal choroiditis and a transient peripapillary white ring. Methods Case report. Results A 39-year-old Asian woman was initially seen for an evaluation of lattice degeneration in 2015. Her medical history included Graves disease and psoriasis. Best-corrected visual acuity was 20/25 in her right eye and 20/25 in her left eye. Ultra-widefield fundus autofluorescence imaging showed a curvilinear hyperautofluorescent line in her right eye. One year later, the patient returned complaining of floaters in her right eye for 1 month. Her visual acuity was unchanged. Funduscopic examination showed new inflammatory yellowish lesions in the right eye corresponding to hyperreflective sub-retinal pigment epithelium lesions on structural spectral domain optical coherence tomography. Fluorescein angiography showed corresponding late staining of these active lesions. Late-phase indocyanine green angiography showed multiple nummular hypocyanescent dots. Ultra-widefield fundus autofluorescence showed large areas of hyperautofluorescence. The patient was started on a 60-mg oral prednisone taper and demonstrated subsequent regression of the inflammatory lesions. Ten months later, the patient returned emergently with complaints of floaters in both eyes for 2 days and a new temporal scotoma in her left eye. Funduscopic examination demonstrated a white ring around the optic nerve of the left eye corresponding to a hyperautofluorescent lesion. Ultra-widefield fundus autofluorescence showed new areas of hyperautofluorescence in both eyes. Structural spectral domain optical coherence tomography showed new sub-retinal pigment epithelium inflammatory lesions and a disruption of the ellipsoid zone in both eyes. The patient was again treated with a 60-mg oral prednisone taper and demonstrated subsequent restoration of the ellipsoid zone. Conclusion To our knowledge, this is the first report of a transient annular white ring occurring in a case of multifocal choroiditis. There was marked restoration of the disrupted ellipsoid zone after treatment with oral corticosteroids. |
| Databáze: | OpenAIRE |
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