Título

APPEARENCE OF NEOVASCULARIZATION AS FIRST MANIFASTATION IN THE RECURRENCE OF MULTIFOCAL CHOROIDITIS ASSOCIATEDE WITH MEWDS

Introdução / Purpose

To report a case of Multifocal Choroiditis (MC) that recurred with sub-retinal neovascular membrane in the contralateral eye followed by a mixed aspect of Multiple Evanescet White Dot Syndrome (MEWDS) and MC.

Material e Método / Methods

Case report: A 39-year-old female with a previous history of supposed MEWDS in the left eye (LE) that progressed with MC seven years later in this eye and eleven years later in the right eye (RE), in the latter case starting with neovascularization subretinal that evolved with MEWDS

Resultados / Results

In this case, the sub-macular neovascular membrane in LE appeared seven years after the supposed MEWDS, but with lesions characteristic of MC, and 11 years in RE within a chorioretinal lesion outside the macular area, inactivated readily with anti-vegf therapy.
Curiously, there was a lesion reactivated in LE, symmetrical to that in the contralateral eye, but without leakage.
Two weeks after the onset of symptoms, FA demonstrated in RE hyperfluorescent spots arranged in circles, focal erasure of the ellipsoid zone (which was reconstituted at follow up) and granular macula, characterizing an MEWDS’s aspect. Four months later, with no sign of activity, there were yellow atrophic lesions in the posterior pole compatible with MC, closing the inflammatory circuit.

Discussão e Conclusões / Discussion

MC and MEWDS are probably part of the same spectrum of diseases, more intimately than others, within the white dots syndrome, perhaps mediated by an immune process that would trigger one or the other, or both.

Palavras Chave

"NEOVASCULARIZATION" "MULTIFOCAL CHOROIDITIS" "MEWDS"