Posterior & Placoid
𝘈𝘤𝘶𝘵𝘦 𝘱𝘰𝘴𝘵𝘦𝘳𝘪𝘰𝘳 𝘮𝘶𝘭𝘵𝘪𝘧𝘰𝘤𝘢𝘭 𝘱𝘭𝘢𝘤𝘰𝘪𝘥 𝘱𝘪𝘨𝘮𝘦𝘯𝘵 𝘦𝘱𝘪𝘵𝘩𝘦𝘭𝘪𝘰𝘱𝘢𝘵𝘩𝘺 (𝘈𝘗𝘔𝘗𝘗𝘌)
● White Dot Syndrome
● Inflammatory chorioretinopathy which was first described by Gass in 1968.
● Bilateral, M=F, 20-40 years
● Association with HLAB7 and HLADR2,
● Could be an immune driven vascular alteration
𝘊𝘰𝘯𝘥𝘪𝘵𝘪𝘰𝘯𝘴 𝘢𝘴𝘴𝘰𝘤𝘪𝘢𝘵𝘦𝘥 𝘸𝘪𝘵𝘩 𝘈𝘗𝘔𝘗𝘗𝘌
𝘐𝘯𝘧𝘦𝘤𝘵𝘪𝘰𝘶𝘴
● Group A streptococcal
● Adenovirus type 5
● Tuberculosis
● Lyme disease
● Mumps
● Hepatitis B vaccination
𝘕𝘰𝘯𝘪𝘯𝘧𝘦𝘤𝘵𝘪𝘰𝘶𝘴
● Erythema nodosum
● Wegener granulomatosis
● PAN
● Cerebral vasculitis
● Scleritis
● Episcleritis
● Sarcoidosis
● Ulcerative colitis
𝗦𝘆𝗺𝗽𝘁𝗼𝗺𝘀:
● Preceding viral or flu like illness
● Rapid onset of blurred vision bilaterally, and asymmetric
● Fellow eye involved within days to weeks
● Central and paracentral scotomas
● Photopsias before vision loss
● Headache and neurological symptoms
𝗦𝗶𝗴𝗻𝘀:
● VA 20/40- CF
● Mild anterior uveitis
● Mild to moderate vitritis 50%
● 𝙁𝙪𝙣𝙙𝙪𝙨 - 𝙢𝙪𝙡𝙩𝙞𝙥𝙡𝙚 𝙛𝙡𝙖𝙩 𝙗𝙞𝙡𝙖𝙩𝙚𝙧𝙖𝙡 𝙮𝙚𝙡𝙡𝙤𝙬-𝙬𝙝𝙞𝙩𝙚 𝙥𝙡𝙖𝙘𝙤𝙞𝙙 𝙡𝙚𝙨𝙞𝙤𝙣𝙨 𝙖𝙩 𝙡𝙚𝙫𝙚𝙡 𝙤𝙛 𝙍𝙋𝙀 𝙖𝙣𝙙 𝙘𝙝𝙤𝙧𝙤𝙞𝙙 𝟷-𝟸 𝙙𝙞𝙨𝙘 𝙙𝙞𝙖𝙢𝙚𝙩𝙚𝙧𝙨 𝙥𝙤𝙨𝙩𝙚𝙧𝙞𝙤𝙧 𝙩𝙤 𝙚𝙦𝙪𝙖𝙩𝙤𝙧
● New peripheral lesions can appear in a linear or radial array over the next 3 weeks
● Papillitis seen, CME uncommon
● Atypical findings- retinal vasculitis, RVOs, retinal neovascularization, exudative RDs
● Fade over 1-2 weeks, resolves over 2-6 weeks
● Older lesions --- well defined alteration in RPE consisting of alternating areas of depigmentation and hyperpigmentation due to pigment clumping
● Variant - relentless placoid chorioretinitis - has features of APMPPE and serpiginous choroiditis
Investigations and Management to follow soon.
www.ophthalmobytes.com
Image from Rajan Eye Care Hospital #ophthalmology #ophthal #doctor #health #medical #vision #education #optometry #medicalstudent #optometrist #medicine #eye #ophtho #ophthalmologist #ophthalmo #med #medicaleducation #ophthalmologyresident #ophthalmologyresidency #retina #apmppe #whitedotsyndrome #placoid #macula #posteriorpole
