Machida Shigeki, Fujiwara Takamitsu, Murai Ken-Ichi, Kubo Masabumi, Kurosaka Daijiro
Department of Ophthalmology, Iwate Medical University School of Medicine, Iwate, Japan.
Retina. 2008 May;28(5):703-10. doi: 10.1097/IAE.0b013e318160798f.
We describe four patients with idiopathic choroidal neovascularization (ICNV) who developed inflammatory chorioretinal diseases in the ipsilateral or contralateral eye.
The medical records of 58 eyes of 58 patients with an initial diagnosis of ICNV (age range, 19-49 years; mean, 34.9 years) were reviewed.
Of the 58 patients, 4 women (7.0%) with moderate to high myopia (age range, 17-39 years) developed inflammatory chorioretinal diseases. In Cases 1 and 2, white dots were transiently seen in the deep retina of the contralateral eye, consistent with the clinical features of multiple evanescent white dot syndrome (MEWDS). In Case 3, vitritis and multifocal white spots emerged in the ipsilateral eye. These white spots spread throughout the ocular fundus and progressed to punched-out chorioretinal scars, which led to a diagnosis of multifocal choroiditis (MFC). In Case 4, an enlarged blind spot and a few chorioretinal scars around the optic nerve head developed without vitritis in the ipsilateral eye, suggesting a diagnosis of punctate inner choroidopathy (PIC).
These findings suggest that ICNV can be an early manifestation of inflammatory chorioretinal diseases, including MEWDS, MFC, and PIC.
我们描述了4例特发性脉络膜新生血管(ICNV)患者,他们在同侧或对侧眼发生了炎性脉络膜视网膜疾病。
回顾了58例初诊为ICNV患者(年龄范围19 - 49岁;平均34.9岁)的58只眼的病历。
在58例患者中,4名女性(7.0%)患有中度至高度近视(年龄范围17 - 39岁),发生了炎性脉络膜视网膜疾病。在病例1和病例2中,对侧眼的深层视网膜中短暂出现白色小点,符合多发性一过性白点综合征(MEWDS)的临床特征。在病例3中,同侧眼出现玻璃体炎和多灶性白点。这些白点扩散至整个眼底并发展为凿孔状脉络膜视网膜瘢痕,从而诊断为多灶性脉络膜炎(MFC)。在病例4中,同侧眼出现盲点扩大和视神经乳头周围的一些脉络膜视网膜瘢痕,无玻璃体炎,提示诊断为点状内层脉络膜病变(PIC)。
这些发现表明,ICNV可能是包括MEWDS、MFC和PIC在内的炎性脉络膜视网膜疾病的早期表现。