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

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Title: Acquired focal choroidal excavation associated with multiple evanescent white dot syndrome: observations at onset and a pathogenic hypothesis
Authors: Hashimoto, Yuki Browse this author
Saito, Wataru Browse this author
Noda, Kousuke Browse this author →KAKEN DB
Ishida, Susumu Browse this author →KAKEN DB
Keywords: Choroidal thickness
Enhanced depth imaging optical coherence tomography
Focal choroidal excavation
Multiple evanescent white dot syndrome
Issue Date: 20-Nov-2014
Publisher: Biomed Central
Journal Title: BMC ophthalmology
Volume: 14
Start Page: 135
Publisher DOI: 10.1186/1471-2415-14-135
Abstract: 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). 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.
Rights: http://creativecommons.org/licenses/by/4.0
Type: article
URI: http://hdl.handle.net/2115/58061
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 齋藤 航

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