Nicolau Zaira Fernanda Martinho, Araújo Diego Lisboa, Nakayama Luis Filipe, Bergamo Vinicius Campos, Meirelles Rodrigo Luz, Júnior Octaviano Magalhães
Department of Ophthalmology, Universidade Federal de São Paulo-Escola Paulista de Medicina-São Paulo (SP), Botucatu st., 806. Vila Clementino, São Paulo, 04023-062, Brazil.
Int J Retina Vitreous. 2022 Apr 5;8(1):25. doi: 10.1186/s40942-022-00372-6.
This manuscript describes a case of a patient with presumed ocular tuberculosis masquerading as multiple evanescent white dot syndrome.
A 32-year-old male patient presented with a complaint of reduced visual acuity in the left eye. Retinal fundus exam of the left eye revealed gray-whitish deep lesions predominantly nasal to the optic disc. The lesions were more clearly identifiable on fundus autofluorescence (FAF) imaging, fluorescein angiography (FA) and en face optical coherence tomography (OCT). FA also indicated retinal vasculitis and papillitis. Swept-source OCT B-scan demonstrated loss of the ellipsoid layer in the regions corresponding to the lesions detected by FAF. A positive tuberculin skin test (TST) confirmed presumed tuberculosis, and a related WDS diagnosis was made. Specific antituberculosis therapy was instituted with favorable anatomical recovery and visual outcome.
Multiple evanescent white dot syndrome (MEWDS) may be manifestation of presumed ocular tuberculosis, and multimodal retinal exams can provide a better understanding of atypical diseases and their follow-up.
本手稿描述了一例疑似眼结核伪装成多发性一过性白点综合征的患者病例。
一名32岁男性患者因左眼视力下降前来就诊。左眼视网膜眼底检查发现灰白色深部病变，主要位于视盘鼻侧。这些病变在眼底自发荧光（FAF）成像、荧光素血管造影（FA）和正面光学相干断层扫描（OCT）上更清晰可见。FA还显示视网膜血管炎和视乳头炎。扫频源OCT B扫描显示在与FAF检测到的病变相对应的区域椭圆体层缺失。结核菌素皮肤试验（TST）呈阳性，证实为疑似结核病，并做出了相关的WDS诊断。开始进行特异性抗结核治疗，取得了良好的解剖学恢复和视觉效果。
多发性一过性白点综合征（MEWDS）可能是疑似眼结核的表现，多模式视网膜检查可以更好地了解非典型疾病及其随访情况。
