Fundus autofluorescence and spectral-domain optical coherence tomography findings of leopard spots in nanophthalmic uveal effusion syndrome

Okuda, Tetsuhiko; Higashide, Tomomi; Wakabayashi, Yuka; Nishimura, Akira; Sugiyama, Kazuhisa

doi:10.1007/s00417-010-1352-7

Cited by 16 publications

(8 citation statements)

References 9 publications

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“…HDS in the ICGA have also been observed in other disorders such as nanophthalmos, uveal effusion syndrome, posterior scleritis, angioid streaks, and a rare case of central serous chorioretinopathy [22][23][24][25][26]. HDS in our case series were different from other disorders in that there were no fundus changes such as Leopard spots and no permanent retinal pigment epithelial changes.…”

Section: Discussionmentioning

confidence: 42%

Angiographic Features of Drug-Induced Bilateral Angle Closure and Transient Myopia with Ciliochoroidal Effusion

Kang

Son

Park

et al. 2019

Preprint

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Background: To report five cases of acute drug-induced bilateral angle closure and transient myopia with ciliochoroidal effusion, and to suggest a pathogenesis for this condition based upon angiography. Methods: This study is an observational case series. Five patients with acute drug-induced angle closure with ciliochoroidal effusion were examined by ultrasound biomicroscopy, fluorescein angiography, and indocyanine green angiography (ICGA). Results: Five patients presented with bilateral visual impairment and ocular pain after treatment with mefenamic acid, phendimetrazine tartrate, topiramate, or methazolamide. All patients presented a shallow anterior chamber and elevated intraocular pressure in both eyes. They showed a myopic shift from -0.5 to -17.0 diopters. Ultrasound biomicroscopy revealed annular ciliochoroidal effusions with diffuse thickening of the ciliary body in all cases. Rapid clinical improvement occurred in all patients after discontinuing the suspected drugs. ICGA findings were classified into two major signs (hypofluorescent dark spots and hyperfluorescent pinpoints) and three minor signs (early choroidal stromal vessel hyperfluorescence and leakage, diffuse hyperfluorescence of the choroid, and tortuous and dilated retinal vessels). Conclusions: The basic mechanism of pathogenesis involved an idiosyncratic reaction in uveal tissue to systemic drugs. Angiography showed that accumulation of extravascular fluid in the ciliochoroidal layer had a major role in pathogenesis. Angiography could therefore be a useful method to examine the pathophysiology of this condition by imaging of the choroidal layer.

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Section: Discussionmentioning

confidence: 42%

Angiographic Features of Drug-Induced Bilateral Angle Closure and Transient Myopia with Ciliochoroidal Effusion

Kang

Son

Park

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…HDS in the ICGA have also been observed in other disorders such as nanophthalmos, uveal effusion syndrome, posterior scleritis, angioid streaks, and a rare case of central serous chorioretinopathy [21][22][23][24][25]. HDS in our case series were different from other disorders in that there were no fundus changes such as Leopard spots and no permanent retinal pigment epithelial changes.…”

Section: Discussionmentioning

confidence: 42%

Angiographic Features of Drug-Induced Bilateral Angle Closure and Transient Myopia with Ciliochoroidal Effusion

Kang

Son

Park

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: To report five cases of acute drug-induced angle closure and transient myopia with ciliochoroidal effusion and to analyze angiographic findings of these cases. Methods: This study is an observational case series. Five patients with acute drug-induced angle closure and transient myopia with ciliochoroidal effusion were examined by fluorescein angiography, indocyanine green angiography (ICGA) and ultrasound biomicroscopy (UBM). Results: Five patients presented with bilateral visual loss and ocular pain after intake of topiramate, methazolamide, phendimetrazine tartrate or mefenamic acid. All patients showed elevated intraocular pressure (IOP) with shallow anterior chamber and myopic shift from -0.5 to -17.0 diopters (D). UBM showed ciliochoroidal effusions with diffuse thickening of the ciliary body in all cases. Rapid normalization of IOP and decrease of myopic shift occurred in all patients after discontinuing the suspected drugs. We classified the ICGA findings into 2 major signs (hypofluorescent dark spots, hyperfluorescent pinpoints) and 3 minor signs (diffuse choroidal hyperfluorescence, early hyperfluorescence of choroidal stromal vessel, and leakage and dilated retinal vessels). Conclusions: The pathogenesis of acute drug-induced angle closure and transient myopia with ciliochoroidal effusion may be idiosyncratic reaction of uveal tissue to systemic drugs. Accumulation of extravascular fluid in the ciliochoroidal layer had a major role in the pathogenesis. ICGA could be a useful method to examine the pathophysiology of this condition by imaging of the choroidal layer. Keywords: Ciliochoroidal effusion; Drug-induced angle closure; Indocyanine green angiography; Transient myopia.

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“…[ 17 , 18 ] Leopard spots by proliferation and migration of RPE cells are observe in uveal effusion syndrome, [ 5 ] that are presented by multiple hypofluorescent spots on FA and ICGA. [ 6 , 17 , 18 ] Furthermore, Okuda et al [ 19 ] reported FAF images of leopard spots showing hyperautofluorescence in a patient with uveal effusion syndrome. In our patient, the eyeball size was not small but normal or rather large, and the findings of fundus, angiographic and FAF images were consistent with those of uveal effusion syndrome.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy-induced hypertension-related chorioretinitis resembling uveal effusion syndrome

Sato

Takeuchi²

2018

Medicine

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Rationale:Pregnancy-induced hypertension (PIH) is a major cause of maternal and fetal mortality. Hypertensive choroidopathy is a preliminary sign of vasogenic edema in the choroid, and is associated with PIH. Here, we report a post-natal case of PIH-related chorioretinitis with bilateral severe serous retinal detachment (SRD) resembling uveal effusion syndrome.Patient concerns:A 35-year-old woman was diagnosed with severe PIH at 37 weeks of pregnancy. She underwent an emergency cesarean delivery. Four days after delivery, she perceived a sudden decrease of vision. At presentation, fundus examination demonstrated bullous SRD and multiple white mottles in the posterior poles of both eyes. Optical coherence tomography (OCT) showed macula edema and retinal pigment epithelium (RPE) folds. Indocyanine green angiography (ICGA) demonstrated delayed filling of choroidal circulation in the early phase and multiple hyperfluorescent spots in the mid phase.Diagnoses:PIH.Interventions:Antihypertension treatment alone resulted in gradual resolution of the SRD.Outcomes:At 463 days after delivery, fundus photographs of both eyes showed leopard spots corresponding to hyperautofluorescent spots with dark rim observed on fundus autofluorescence images.Lessons:Ophthalmologists should be aware of PIH-related chorioretinitis with similar clinical manifestations as uveal effusion syndrome, and should treat with antihypertensive agents in cooperation with obstetricians.

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Fundus autofluorescence and spectral-domain optical coherence tomography findings of leopard spots in nanophthalmic uveal effusion syndrome

Abstract: Okuda et al. FAF and SD-OCT findings of leopard spots in uveal effusion-1 - -----------Case Report----------- Fundus

Cited by 16 publications

References 9 publications

Angiographic Features of Drug-Induced Bilateral Angle Closure and Transient Myopia with Ciliochoroidal Effusion

Angiographic Features of Drug-Induced Bilateral Angle Closure and Transient Myopia with Ciliochoroidal Effusion

Angiographic Features of Drug-Induced Bilateral Angle Closure and Transient Myopia with Ciliochoroidal Effusion

Pregnancy-induced hypertension-related chorioretinitis resembling uveal effusion syndrome

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