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. 2017 Mar 2:23:1106-1115.
doi: 10.12659/msm.901744.

Observation and Clinical Pattern in Patients with White Dot Syndromes: The Role of Color Photography in Monitoring Ocular Changes in Long-Term Observation

Joanna Brydak-Godowska  1 , Joanna Gołębiewska  2 , Monika Turczyńska  1 , Joanna Moneta-Wielgoś  1 , Agnieszka Samsel  3 , Piotr K Borkowski  4 , Michał Ciszek  5 , Agnieszka Płonecka-Rodzoch  1 , Aleksandra Kużnik-Borkowska  1 , Joanna Ciszewska  1 , Elżbieta Makomaska-Szaroszyk  6 , Lidia B Brydak  7 , Dariusz Kęcik  1
Affiliations

Observation and Clinical Pattern in Patients with White Dot Syndromes: The Role of Color Photography in Monitoring Ocular Changes in Long-Term Observation

Joanna Brydak-Godowska et al. Med Sci Monit. .

Abstract

BACKGROUND The aim of this study was to assess the clinical course and distinctive features of different white dot syndromes (WDS) in patients attending the Ophthalmology Department, Medical University of Warsaw in the years 1995-2015. MATERIAL AND METHODS Sixty-two (62) patients (43 females and 19 males), aged 18 to 77 years, referred with a WDS were included in this prospective study, with observation period ranging from 5 months to 16 years. All patients underwent a complete ophthalmological examination and multimodal imaging studies. RESULTS In this cohort of 62 patients, the following WDS entities were identified: multifocal choroiditis with panuveitis (MFCPU), multifocal choroiditis (MFC), punctate inner choroidopathy (PIC), birdshot, acute posterior multifocal placoid pigment epitheliopathy (APMPPE), subretinal fibrosis and uveitis, multiple evanescent white dot syndrome (MEWDS), serpiginous choroiditis, and single cases of acute annular outer retinopathy (AAOR). CONCLUSIONS The study was performed at a Polish referral center and may to some extent reflect the varied geographical distribution of white dot syndromes, as none of the subjects was found to suffer from acute zonal occult outer retinopathy (AZOOR), acute macular neuroretinopathy (AMN), or diffuse unilateral subacute neuroretinitis (DUSN). Long-term follow-up is warranted by the evolution of lesions in the eye fundus, while management depends on correct diagnosis of WDS. When the posterior pole is involved in some cases of the WDS an immunosuppressive treatment, the use of the PDT or anti-VEGF injections were necessary.

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Conflict of interest statement

Declaration of interest

All the authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Lesions in the fundus of the right eye (2003). A star-shaped fibrotic lesion and several irregular atrophic foci in the posterior pole.
Figure 2
Figure 2
Lesions in the fundus of the left eye (2003). Foci of atrophy with pigment accumulation.
Figure 3
Figure 3
Lesions in the fundus of the right eye (2009). A large fibrotic scar in the macula and numerous various-sized pigmented atrophic foci in the posterior pole.
Figure 4
Figure 4
Lesions in the fundus of the left eye (2009). A fibrotic scar in the macula and numerous pigmented atrophic foci. The lesions were less advanced than in the right eye.
Figure 5
Figure 5
Photograph of the left eye on diagnosis: small atrophic foci in the macula and at the optic disc. The atrophic rim visible at the lower edge of the optic disc.
Figure 6
Figure 6
Photograph of the left eye 3 years later: widening of the atrophic rim around the optic disc. Small atrophic foci with pigment visible within some of the foci.
Figure 7
Figure 7
Photograph of the fundus of the right eye with the atrophic rim around the optic disc. A fibrotic scar and whitish, washed-out, irregularly shaped foci in the macula.
Figure 8
Figure 8
Whitish, irregularly shaped foci on the nasal side of the optic disc.
Figure 9
Figure 9
Photograph of the fundus of the left eye with the atrophic rim around the optic disc. A hemorrhage spot and whitish irregularly shaped foci in the macula.
Figure 10
Figure 10
Whitish, irregularly shaped foci visible on the nasal side of the optic disc. The fundus of the left eye 18 months later. Progression of the macular fibrosis and the foci on the nasal side of the optic disc.
Figure 11
Figure 11
Photograph of the fundus of the right eye 18 months later. Progression of the macular fibrosis.
Figure 12
Figure 12
Photograph of the fundus of the right eye 18 months later. Progression of the focal fibrosis on the nasal side of the optic disc.
Figure 13
Figure 13
The fundus of the left eye 18 months later. Progression of the macular fibrosis.
Figure 14
Figure 14
The fundus of the left eye 18 months later. Progression of the focal fibrosis and on the nasal side of the optic disc.
Figures 15
Figures 15
(A, B) Washed-out, creamy foci of inflammation in the macular region of the right eye and below the optic disc in the left eye (1999).
Figures 16
Figures 16
(A, B) Diffuse foci of chorioretinal atrophy and accumulations of pigment (2002).
Figures 17
Figures 17
(A, B) (2006), (C, D) (2009), (E, F) (2015). Increases in the areas of chorioretinal atrophy and the extent of pigment dispersion in long-term observation.
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