There is Something Strange and Unusual at the Back of the Eye
Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen in Practical Emergency Ophthalmology Handbook, 2019
Other choroidal lesions of a worrying nature include metastasis from a systemic malignancy. Solid lesions tend to be multiple and creamy white in nature, very much larger than seen in white dot syndromes and as such are difficult to confuse with one another. Unlike melanoma, metastases tend to be flatter, exude fluid, and may demonstrate RPE clumps. The most common primary sites are the breasts in women and the lungs in men.
The Clinical Characteristics of Unilateral Placoid Pigment Epitheliopathies
Published in Ocular Immunology and Inflammation, 2021
Isil Kutluturk, Aniruddha Agarwal, Shiri Shulman, Albert Vitale, Maurizio B. Parodi, Christoph D. Conrady, Katarina Hurtikova, Eduardo Cunha Souza, Ever Caso Rodriguez, Jay Chhablani, Christoph Tappeiner, Heinrich Gerding, Martin S. Zinkernagel, William Tucker, Marion R. Munk
Acute posterior multifocal placoid pigment epitheliopathy (APMPPE), which was first described by Gass in 1968, still bears mysteries. It belongs to the spectrum of White Dot Syndromes, occurs mostly at young ages (20–40 aged), and is encountered at similar rates in both men and women. APMPPE is often preceded by flu-like symptoms and/or accompanied by neck stiffness or headache. Its occurrence after viral infections, vaccines or drug intake suggests an autoimmune origin1-3 In contrast to APMPPE, relentless placoid choroiditis (RPC) is not limited to the posterior pole, demonstrates prolonged periods of activity, and is characterized by continuous development of new lesions. Also, peripapillary involvement is a common finding and healing of lesions show more extensive choroidal atrophy than in APMPPE.4
Review of the Current Literature and Our Experience on the Value of OCT-angiography in White Dot Syndromes
Published in Ocular Immunology and Inflammation, 2022
Céline Mebsout-Pallado, Raphaëlle Orès, Céline Terrada, Kunal K. Dansingani, Jay Chhablani, Andrew W. Eller, Joseph N. Martel, Alexander Anetakis, Jean C. Harwick, Evan L. Waxman, Denise S. Gallagher, Colin Prensky, Chad Indermill, Neila Sedira, Emmanuel Héron, Michel Paques, Françoise Brignole-Baudouin, Bahram Bodaghi, José-Alain Sahel, Alain Gaudric, Sarah Mrejen, Marie-Hélène Errera
The term “white dot syndromes” is used to refer to a heterogeneous group of chorioretinal inflammatory diseases. Apart from grouping these conditions and reminding us that they can feature multiple inflammatory lesions in various configurations, the term “white dot syndrome” is of limited value as it does not convey useful information about etiology, classification, or treatment of these conditions. In addition, other uveitis may take on the appearance of white spot syndrome such as those associated with tuberculosis or syphilis for example. It is important to try to distinguish the etiologies underlying “white dot syndromes” because their causes may vary and their treatments differ.
Multimodal Imaging of Post-Infectious Unilateral Outer Retinopathy and Choroiditis
Published in Ocular Immunology and Inflammation, 2019
Shilpa Kodati, Sapna Gangaputra, H. Nida Sen
An infectious trigger to the white dot syndromes has been proposed.11 Multiple mechanisms have been proposed to account for the development of a post-infectious autoimmune response, including molecular mimicry, viral and bacterial superantigen-mediated T cell activation, epitope spreading, bystander activation, and lymphotropic viral activation of lymphocytes.12 Due to the temporal relationship of the onset of his decreased vision following symptoms consistent with an infection, we think that this presentation is likely to be a post-infectious in etiology, although we have no serological evidence of an acute infection.
Related Knowledge Centers
- Birdshot Chorioretinopathy
- Multiple Evanescent White Dot Syndrome
- Retinal Pigment Epithelium
- Fundus
- Acute Posterior Multifocal Placoid Pigment Epitheliopathy
- Acute Zonal Occult Outer Retinopathy
- Multifocal Choroiditis & Panuveitis
- Punctate Inner Choroiditis
- Serpiginous Choroiditis
- Macular Scarring