2024-03-28T11:22:43Zhttps://eprints.lib.hokudai.ac.jp/dspace-oai/requestoai:eprints.lib.hokudai.ac.jp:2115/580612022-11-17T02:08:08Zhdl_2115_20040hdl_2115_121Acquired focal choroidal excavation associated with multiple evanescent white dot syndrome: observations at onset and a pathogenic hypothesisHashimoto, YukiSaito, WataruNoda, KousukeIshida, SusumuChoroidal thicknessEnhanced depth imaging optical coherence tomographyFocal choroidal excavationMultiple evanescent white dot syndrome490Background: 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). 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'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. Conclusions: These 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.Biomed CentralJournal Articleapplication/pdfhttp://hdl.handle.net/2115/58061https://eprints.lib.hokudai.ac.jp/dspace/bitstream/2115/58061/1/1471-2415-14-135.pdf1471-2415BMC ophthalmology141352014-11-20enginfo:doi/10.1186/1471-2415-14-135http://creativecommons.org/licenses/by/4.0publisher