A Case of Punctate Inner Choroidopathy Followed by Multiple Evanescent White Dot Syndrome
10.3341/jkos.2018.59.9.881
- Author:
Su Youn SUH
1
;
Jong Ho PARK
;
Seung Min LEE
;
Sung Who PARK
;
Ji Eun LEE
;
Ik Soo BYON
Author Information
1. Research Institute for Convergence of Biomedical Science and Technology, Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, Korea. isbyon@pusan.ac.kr
- Publication Type:Case Report
- Keywords:
Multiple evanescent white dot syndrome;
Punctate inner choroidopathy;
White dot syndrome
- MeSH:
Angiography;
Bevacizumab;
Choroidal Neovascularization;
Female;
Fluorescein Angiography;
Hemorrhage;
Humans;
Indocyanine Green;
Intravitreal Injections;
Optic Disk;
Photography;
Pigmentation;
Switzerland;
Tomography, Optical Coherence;
Vision Disorders;
Visual Acuity;
Visual Fields;
Young Adult
- From:Journal of the Korean Ophthalmological Society
2018;59(9):881-886
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To report a delayed onset of multiple evanescent white dot syndrome in a patient with punctate inner choroidopathy. CASE SUMMARY: A 23-year-old female complained about sudden visual loss in the right eye. Best-corrected visual acuity (BCVA) was 20/100 in the right eye and 20/20 in the left eye. In fundus examination and optical coherence tomographic images, subfoveal choroidal neovascularization (CNV) with hemorrhage was observed in the right eye, accompanied by multiple lesions of atrophic pigmentation on the posterior pole in both eyes. We diagnosed the patient as punctate inner choroidopathy (PIC) and CNV in the right eye, and treated her using three monthly intravitreal injections of bevacizumab (Avastin®, Roche, Basel, Switzerland; 1.25 mg/0.05 mL). The CNV regressed and the BCVA improved to 20/20. Two years later, she complained of visual impairment in her left eye. The BCVA was 20/40. Fundus photography revealed numerous small white dots around the posterior pole and optic disc. Disruption of the photoreceptor layer was seen in optical coherence tomography images. Small white dots were observed as multiple hyperfluorescent dots in fluorescein angiography and hypofluorescent spots in indocyanine green angiography. An enlarged blind spot was observed in the visual field. We diagnosed her as multiple evanescent white dot syndrome (MEWDS). One month after systemic steroid treatment, the multiple white dots disappeared and the BCVA improved to 20/20. CONCLUSIONS: We determined that PIC and MEWDS, which belong to the white dot syndrome, could occur in a patient at different times.
