Posterior and placoid!


๐˜ˆ๐˜ค๐˜ถ๐˜ต๐˜ฆ ๐˜ฑ๐˜ฐ๐˜ด๐˜ต๐˜ฆ๐˜ณ๐˜ช๐˜ฐ๐˜ณ ๐˜ฎ๐˜ถ๐˜ญ๐˜ต๐˜ช๐˜ง๐˜ฐ๐˜ค๐˜ข๐˜ญ ๐˜ฑ๐˜ญ๐˜ข๐˜ค๐˜ฐ๐˜ช๐˜ฅ ๐˜ฑ๐˜ช๐˜จ๐˜ฎ๐˜ฆ๐˜ฏ๐˜ต ๐˜ฆ๐˜ฑ๐˜ช๐˜ต๐˜ฉ๐˜ฆ๐˜ญ๐˜ช๐˜ฐ๐˜ฑ๐˜ข๐˜ต๐˜ฉ๐˜บ (๐˜ˆ๐˜—๐˜”๐˜—๐˜—๐˜Œ)โฃ

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โ— White Dot Syndromeโฃ

โ— Inflammatory chorioretinopathy which was first described by Gass in 1968.โฃ

โ— Bilateral, M=F, 20-40 yearsโฃ

โ— Association with HLAB7 and HLADR2,โฃ

โ— Could be an immune driven vascular alterationโฃ

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๐˜Š๐˜ฐ๐˜ฏ๐˜ฅ๐˜ช๐˜ต๐˜ช๐˜ฐ๐˜ฏ๐˜ด ๐˜ข๐˜ด๐˜ด๐˜ฐ๐˜ค๐˜ช๐˜ข๐˜ต๐˜ฆ๐˜ฅ ๐˜ธ๐˜ช๐˜ต๐˜ฉ ๐˜ˆ๐˜—๐˜”๐˜—๐˜—๐˜Œ โฃ

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๐˜๐˜ฏ๐˜ง๐˜ฆ๐˜ค๐˜ต๐˜ช๐˜ฐ๐˜ถ๐˜ดโฃ

โ— Group A streptococcalโฃ

โ— Adenovirus type 5โฃ

โ— Tuberculosisโฃ

โ— Lyme diseaseโฃ

โ— Mumpsโฃ

โ— Hepatitis B vaccinationโฃ

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๐˜•๐˜ฐ๐˜ฏ๐˜ช๐˜ฏ๐˜ง๐˜ฆ๐˜ค๐˜ต๐˜ช๐˜ฐ๐˜ถ๐˜ดโฃ

โ— Erythema nodosumโฃ

โ— Wegener granulomatosisโฃ

โ— PANโฃ

โ— Cerebral vasculitisโฃ

โ— Scleritisโฃ

โ— Episcleritisโฃ

โ— Sarcoidosisโฃ

โ— Ulcerative colitisโฃ

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๐—ฆ๐˜†๐—บ๐—ฝ๐˜๐—ผ๐—บ๐˜€:โฃ

โ— Preceding viral or flu like illnessโฃ

โ— Rapid onset of blurred vision bilaterally, and asymmetricโฃ

โ— Fellow eye involved within days to weeksโฃ

โ— Central and paracentral scotomasโฃ

โ— Photopsias before vision lossโฃ

โ— Headache and neurological symptomsโฃ

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๐—ฆ๐—ถ๐—ด๐—ป๐˜€:โฃ

โ— VA 20/40- CFโฃ

โ— Mild anterior uveitisโฃ

โ— Mild to moderate vitritis 50%โฃ

โ— ๐™๐™ช๐™ฃ๐™™๐™ช๐™จ - ๐™ข๐™ช๐™ก๐™ฉ๐™ž๐™ฅ๐™ก๐™š ๐™›๐™ก๐™–๐™ฉ ๐™—๐™ž๐™ก๐™–๐™ฉ๐™š๐™ง๐™–๐™ก ๐™ฎ๐™š๐™ก๐™ก๐™ค๐™ฌ-๐™ฌ๐™๐™ž๐™ฉ๐™š ๐™ฅ๐™ก๐™–๐™˜๐™ค๐™ž๐™™ ๐™ก๐™š๐™จ๐™ž๐™ค๐™ฃ๐™จ ๐™–๐™ฉ ๐™ก๐™š๐™ซ๐™š๐™ก ๐™ค๐™› ๐™๐™‹๐™€ ๐™–๐™ฃ๐™™ ๐™˜๐™๐™ค๐™ง๐™ค๐™ž๐™™ ๐Ÿท-๐Ÿธ ๐™™๐™ž๐™จ๐™˜ ๐™™๐™ž๐™–๐™ข๐™š๐™ฉ๐™š๐™ง๐™จ ๐™ฅ๐™ค๐™จ๐™ฉ๐™š๐™ง๐™ž๐™ค๐™ง ๐™ฉ๐™ค ๐™š๐™ฆ๐™ช๐™–๐™ฉ๐™ค๐™งโฃ

โ— New peripheral lesions can appear in a linear or radial array over the next 3 weeksโฃ

โ— Papillitis seen, CME uncommonโฃ

โ— Atypical findings- retinal vasculitis, RVOs, retinal neovascularization, exudative RDsโฃ

โ— Fade over 1-2 weeks, resolves over 2-6 weeksโฃ

โ— Older lesions --- well defined alteration in RPE consisting of alternating areas of depigmentation and hyperpigmentation due to pigment clumpingโฃ

โ— Variant - relentless placoid chorioretinitis - has features of APMPPE and serpiginous choroiditisโฃ

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Investigations and Management to follow soon. โฃ

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www.ophthalmobytes.comโฃ

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