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多灶性脉络膜炎/点状内层脉络膜病变伴多发性一过性白点综合征样特征的多模态影像学特征和转归:一项回顾性研究。

The multimodal imaging features and outcomes of multifocal choroiditis/punctate inner choroidopathy lesion with multiple evanescent white dot syndrome-like features: a retrospective study.

机构信息

Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China.

出版信息

BMC Ophthalmol. 2024 Jan 2;24(1):3. doi: 10.1186/s12886-023-03277-6.

Abstract

BACKGROUND

Multiple evanescent white dot syndrome (MEWDS)-like features is a rare condition triggered by a macular disease or iatrogenic injury, exhibiting MEWDS changes in the fundus. This study aims to describe the multimodal imaging features and outcomes of multifocal choroiditis/punctate inner choroidopathy (MFC/PIC) lesions with MEWDS-like features.

METHODS

Six cases were studied retrospectively. All cases were given regional and oral corticosteroids.

RESULTS

All cases showed an isolated juxtafoveal yellowish-white MFC/PIC lesion with disruption of RPE-Bruch's membrane-choriocapillaris complex (RPE-BM-CC), subretinal hyperreflective materials and choroidal thickening on optical coherence tomography. Two weeks after presentation, the grayish-white dots disappeared spontaneously and the corticosteroids were given. After four weeks, the ellipsoid zone (EZ) around the lesion and hyper-autofluorescence resolved. After 13 weeks, five cases showed shrinkage of the juxtafoveal lesion and restoration of foveal EZ. After six months, the juxtafoveal lesion became pigmented. Only one case developed type 2 choroidal neovascularization.

CONCLUSIONS

The clinical course of MEWDS-like manifestations is still evanescent in our cases. The yellowish-white juxtafoveal MFC/PIC lesions with disruption of RPE-BM-CC and choroidal thickening showed a well-controlled prognosis after corticosteroid treatment.

摘要

背景

多发性一过性白点综合征(MEWDS)样特征是一种罕见的疾病状态,由黄斑疾病或医源性损伤引起,眼底出现 MEWDS 样改变。本研究旨在描述具有 MEWDS 样特征的多灶性脉络膜炎/点状内层脉络膜病变(MFC/PIC)病变的多模态成像特征和结果。

方法

回顾性研究 6 例患者。所有病例均给予局部和口服皮质类固醇治疗。

结果

所有病例均表现为孤立性近黄斑区黄白色 MFC/PIC 病变,伴有 RPE-Bruch 膜脉络膜毛细血管复合体(RPE-BM-CC)、视网膜下高反射物质和脉络膜增厚,光学相干断层扫描显示。在出现后 2 周,灰白色斑点自发消失并开始使用皮质类固醇。4 周后,病变周围的椭圆体带(EZ)和高自发荧光恢复。13 周后,5 例患者近黄斑区病变缩小,黄斑区 EZ 恢复。6 个月后,近黄斑区病变出现色素沉着。仅 1 例发展为 2 型脉络膜新生血管。

结论

在我们的病例中,MEWDS 样表现的临床过程仍然是短暂的。伴有 RPE-BM-CC 破坏和脉络膜增厚的黄白色近黄斑区 MFC/PIC 病变,经皮质类固醇治疗后预后良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9267/10763055/573703757abd/12886_2023_3277_Fig1_HTML.jpg

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