Clinical analysis for a case of multiple evanescent white dot syndrome

Abstract

Objective To observe the change of treatment and to analyze its clinical characteristics of a multiple evanescent white dot syndrome.Methods A case of suspected multiple evanescent white dot syndrome was followed up in outpatient,best corrected visual acuity,fundus examination by preset lens,fundus photography,optical coherence tomography (OCT),fluorescein fundus angiography (FFA)/ indocyanine green angiography (ICGA),visual field and ERG were performed on the first visit and the 25th day,respectively.Prednisone 40mg was administrated.Results The visual acuity of the patient improved gradually,the corrected visual acuity was up to 1.0 on the 45th day.Fundus white dots disappeared gradually,and not to be discemed on the 25th day.Central visual field examination showed that physiological blind spot enlarged in the early stage,which returned to normal on the 25th day.ERG showed that amplitude of wave a decreased significantly in early stage,which still decreased and recovered slowly.OCT scan showed that optic band of retinal pigment epithelium (RPE) and inner photoreceptor segment/outer photoreceptor segment junction (is/os),outer segment photoreceptor/ retinal pigment epithelium complex (OPR) became rough and interrupt in early stage.Optic band of is/os and RPE restored gradually on the 25th day,but reflection of OPR was still rough.High fluorescence of optic disc and vein wall decreased significantly on the 25th day.Conclusions Multiple white spot syndrome can be a special type of chorioretinal inflammation,the pathological damage of which mainly located in the retinal pigment epithelial layer and the layer of photoreceptor cells.Glucocorticoid hormone can effectively control the inflammation,shorten the course of disease. Key words: Multiple evanescent white dot syndrome; Treatment