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急性后极部多发性斑状脉络膜视网膜病变伴视网膜内液的不典型病例。

Atypical case of acute posterior multifocal placoid pigment epitheliopathy with intraretinal fluid.

机构信息

Ophthalmology Department, Hospital Pedro Hispano, Matosinhos, Portugal

Ophthalmology Department, Hospital Pedro Hispano, Matosinhos, Portugal.

出版信息

BMJ Case Rep. 2023 Oct 5;16(10):e255464. doi: 10.1136/bcr-2023-255464.

Abstract

Acute posterior multifocal placoid pigment epitheliopathy is a rare inflammatory chorioretinopathy, classified as a white dot syndrome, in which ischaemia of the choriocapillaris leads to atrophy of the external retinal layers, including the retinal pigment epithelium.A male patient in his 20s presented with sudden severe loss of vision in the left eye. Funduscopy revealed with yellow placoid lesions in the macula and near periphery. Spectral-domain optical coherence tomography and fluorescein angiography revealed the presence of central intraretinal fluid in the left eye and multiple areas of macular ischaemia bilaterally. Treatment with oral corticosteroids was initiated, and the anatomical changes, including the intraretinal fluid, improved steadily over the following weeks.Although rare, the presence of subretinal or intraretinal fluid should not decrease the suspicion of acute posterior multifocal placoid pigment epitheliopathy. Reabsorption of the fluid is usually accompanied by the improvement of the remaining anatomical changes and the visual function.

摘要

急性后部多灶性斑状脉络膜视网膜病变是一种罕见的炎症性脉络膜视网膜病变,归类为白点综合征,其中脉络膜毛细血管缺血导致外视网膜层包括视网膜色素上皮层萎缩。一名 20 多岁的男性患者左眼突然出现严重视力丧失。眼底检查显示黄斑部和周边有黄色斑片状病变。频域光相干断层扫描和荧光素血管造影显示左眼存在中心性视网膜内液和双侧多处黄斑缺血。开始口服皮质类固醇治疗,随后几周内,包括视网膜内液在内的解剖结构变化稳定改善。虽然罕见,但存在视网膜下或视网膜内液不应降低对急性后部多灶性斑状脉络膜视网膜病变的怀疑。液体的吸收通常伴随着剩余解剖结构和视觉功能的改善。

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