Limits...
A case of multiple evanescent white dot syndrome misdiagnosed as optic neuritis: Differential diagnosis for the neurologist.

Pellegrini F, Interlandi E - J Neurosci Rural Pract (2016 Apr-Jun)

Bottom Line: A 25-year-old female presented to a local hospital for acute onset of a central scotoma in the left visual field.After a description of the case, a brief differential diagnosis between these two entities is made.The neurologist should be aware of this uncommon condition.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Conegliano Hospital, Conegliano, Treviso, Italy.

ABSTRACT
A 25-year-old female presented to a local hospital for acute onset of a central scotoma in the left visual field. She was visited by the neurologist, and a diagnosis of left retrobulbar optic neuritis was made. Magnetic resonance imaging scan was normal. Ophthalmic examination revealed a multiple evanescent white dot syndrome. After a description of the case, a brief differential diagnosis between these two entities is made. The neurologist should be aware of this uncommon condition.

No MeSH data available.


Related in: MedlinePlus

Optical coherence tomography scan of the fovea outer segment shows disruption at the inner segment/outer segment junction of photoreceptor layer in the macula
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4821940&req=5

Figure 3: Optical coherence tomography scan of the fovea outer segment shows disruption at the inner segment/outer segment junction of photoreceptor layer in the macula

Mentions: A 25-year-old female presented to a local hospital for acute onset of a central scotoma in the left visual field. The neurologist collected a visual acuity (VA) of 20/20 in OD and 10/20 in OS; pupil examination as well as optic nerve examination by direct ophthalmoscopy was normal. A retrobulbar optic neuritis was suspected so that a contrast brain magnetic resonance imaging scan was requested. This resulted normal with no signs of optic neuritis or multiple sclerosis. She was sent to neuro-ophthalmology, where she presented 2 weeks later. Her past ocular history was positive for mild myopia (−1.75 SF OU); she denied smoke, trauma, or drug consumption, but to specific questioning, the patient reported a flu-like illness 1 month before the onset of her symptoms. She denied pain on eye movement when presented the 1st time with visual loss. The neurologic examination was normal. Her VA was 20/20 in OD and 15/20 in OS. Pupils were equal a briskly reactive to light with no relative afferent pupillary defect (RAPD). Ishihara test was full OD (12/12) but abnormal in OS (7/12); anterior segment examination and intraocular pressure were within normal limits in OU. On fundus examination, a granular appearance of the macula [Figure 1] was evident in OS with some residual white spots in the posterior pole [Figure 2]. Fundus examination in OD was normal. Optical coherence tomography scan of the macula was positive for a disruption of outer retinal layers [Figure 3] well matching the granular appearance of retinography. Autofluorescence [Figure 4] revealed a major number of white spots as compared to fundus examination. The patient refused the consent for visual field and indocyanine green angiography. She was diagnosed with MEWDS and scheduled for control at 3 months.


A case of multiple evanescent white dot syndrome misdiagnosed as optic neuritis: Differential diagnosis for the neurologist.

Pellegrini F, Interlandi E - J Neurosci Rural Pract (2016 Apr-Jun)

Optical coherence tomography scan of the fovea outer segment shows disruption at the inner segment/outer segment junction of photoreceptor layer in the macula
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4821940&req=5

Figure 3: Optical coherence tomography scan of the fovea outer segment shows disruption at the inner segment/outer segment junction of photoreceptor layer in the macula
Mentions: A 25-year-old female presented to a local hospital for acute onset of a central scotoma in the left visual field. The neurologist collected a visual acuity (VA) of 20/20 in OD and 10/20 in OS; pupil examination as well as optic nerve examination by direct ophthalmoscopy was normal. A retrobulbar optic neuritis was suspected so that a contrast brain magnetic resonance imaging scan was requested. This resulted normal with no signs of optic neuritis or multiple sclerosis. She was sent to neuro-ophthalmology, where she presented 2 weeks later. Her past ocular history was positive for mild myopia (−1.75 SF OU); she denied smoke, trauma, or drug consumption, but to specific questioning, the patient reported a flu-like illness 1 month before the onset of her symptoms. She denied pain on eye movement when presented the 1st time with visual loss. The neurologic examination was normal. Her VA was 20/20 in OD and 15/20 in OS. Pupils were equal a briskly reactive to light with no relative afferent pupillary defect (RAPD). Ishihara test was full OD (12/12) but abnormal in OS (7/12); anterior segment examination and intraocular pressure were within normal limits in OU. On fundus examination, a granular appearance of the macula [Figure 1] was evident in OS with some residual white spots in the posterior pole [Figure 2]. Fundus examination in OD was normal. Optical coherence tomography scan of the macula was positive for a disruption of outer retinal layers [Figure 3] well matching the granular appearance of retinography. Autofluorescence [Figure 4] revealed a major number of white spots as compared to fundus examination. The patient refused the consent for visual field and indocyanine green angiography. She was diagnosed with MEWDS and scheduled for control at 3 months.

Bottom Line: A 25-year-old female presented to a local hospital for acute onset of a central scotoma in the left visual field.After a description of the case, a brief differential diagnosis between these two entities is made.The neurologist should be aware of this uncommon condition.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Conegliano Hospital, Conegliano, Treviso, Italy.

ABSTRACT
A 25-year-old female presented to a local hospital for acute onset of a central scotoma in the left visual field. She was visited by the neurologist, and a diagnosis of left retrobulbar optic neuritis was made. Magnetic resonance imaging scan was normal. Ophthalmic examination revealed a multiple evanescent white dot syndrome. After a description of the case, a brief differential diagnosis between these two entities is made. The neurologist should be aware of this uncommon condition.

No MeSH data available.


Related in: MedlinePlus