Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan.
Tameike Eye Clinic, Tokyo, Japan.
Optom Vis Sci. 2022 Sep 1;99(9):730-734. doi: 10.1097/OPX.0000000000001931. Epub 2022 Aug 2.
Unilateral acute idiopathic maculopathy is a rare retinochoroidal disorder, the cause of which is unknown. Multimodal retinal imaging obtained in this case suggests that the cause of unilateral acute idiopathic maculopathy is impaired choroidal circulation.
This study aimed to report a patient with unilateral acute idiopathic maculopathy who showed improvement of choroidal circulation over time in optical coherence tomography angiography images.
A 33-year-old woman with a prodromal flu-like illness noticed a sudden central visual field abnormality in the right eye. Five days after the onset, best-corrected visual acuity was 0.15 in the right eye. Fundus photography showed a yellowish lesion at the macula in the right eye. Optical coherence tomography showed a blurred ellipsoid zone and a thickened retinal pigment epithelium at the fovea and a disrupted/blurred ellipsoid zone and retinal pigment epithelium at the parafovea. Optical coherence tomography angiography segmentation of the choriocapillaris revealed a hypointense region at the fovea with a hyperintense region surrounding it. One week after the onset, best-corrected visual acuity was improved from 0.15 to 2.0 in the right eye. Furthermore, the yellowish macula lesion shrank, and the outer retinal layers showed improvement in optical coherence tomography. Optical coherence tomography angiography showed reduction of the hypointense region and enlargement of the hyperintense region. Approximately 1 year after the onset, the yellowish lesion was faded. Optical coherence tomography revealed an almost normal ellipsoid zone but a thickened interdigitation zone. Optical coherence tomography angiography also revealed an apparent hyperintense instead of the hypointense region and increased choroidal blood flow.
The current patient showed a gradual recovery of choroidal circulation and outer retinal layer morphology 1 year after the onset of unilateral acute idiopathic maculopathy. Optical coherence tomography angiography findings indicated that the primary cause of unilateral acute idiopathic maculopathy was impaired choroidal circulation, and choroidal vessels improved morphologically over the disease course.
单侧急性特发性黄斑病变是一种罕见的视网膜脉络膜疾病，其病因不明。本病例获得的多模态视网膜成像提示，单侧急性特发性黄斑病变的病因是脉络膜循环受损。
本研究旨在报告一例单侧急性特发性黄斑病变患者，其光学相干断层扫描血管造影图像显示脉络膜循环随时间逐渐改善。
一名 33 岁女性，有前驱流感样疾病史，右眼突然出现中央视野异常。发病后 5 天，右眼最佳矫正视力为 0.15。眼底照相显示右眼黄斑区有一个黄色病变。光学相干断层扫描显示黄斑区模糊的椭圆体带和视网膜色素上皮增厚，以及旁黄斑区的椭圆体带破坏/模糊和视网膜色素上皮增厚。脉络膜毛细血管的光学相干断层扫描血管造影分割显示黄斑区有一个低信号区，周围有一个高信号区。发病后 1 周，右眼最佳矫正视力从 0.15 提高到 2.0。此外，黄斑区的黄色病变缩小，外层视网膜在光学相干断层扫描下有所改善。光学相干断层扫描血管造影显示低信号区减少，高信号区扩大。发病后约 1 年，黄斑区的黄色病变消失。光学相干断层扫描显示几乎正常的椭圆体带，但融合带增厚。光学相干断层扫描血管造影也显示明显的高信号而不是低信号区域和增加的脉络膜血流。
本患者在单侧急性特发性黄斑病变发病 1 年后，脉络膜循环和外层视网膜形态逐渐恢复。光学相干断层扫描血管造影结果表明，单侧急性特发性黄斑病变的主要病因是脉络膜循环受损，脉络膜血管在疾病过程中形态学上得到改善。
