Multimodal imaging supporting the pathophysiology of white dot syndromes

Testi, Ilaria; Modugno, Rocco Luigi; Pavésio, Carlos

doi:10.1186/s12348-021-00261-3

Cited by 11 publications

(17 citation statements)

References 40 publications

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“…As the lesions resolve, RPE disruption or atrophy may also occur. OCT-A demonstrates that this changes correlate with greater areas of hypoperfusion at the level of choriocapillaris being detected also on FFA and ICGA [9].…”

Section: Primary Choriocapillaritis 31 Acute Posterior Multifocal Pla...mentioning

confidence: 77%

“…A placoid macular hypoautofluorescence which correlates with poor visual outcome may also be seen [8]. FFA shows optic nerve hyperfluorescence, vascular leakage (predominantly phlebitis), and macular leakage (Figure 1) [9]. Moreover, circulation times are called to be "delayed" in the venous circulation but in fact is a pseudo-delay or "quenching" of the dye due to diffuse capillary leakage of fluorescein into the surrounding tissue so that there is not enough dye to normally mark the veins (Figure 1) [10].…”

Section: Primary Stromal Choroiditis With Additional Independent Reti...mentioning

confidence: 98%

“…The disease origin was first attributed to the RPE by Gass in 1968 [21]; hence the name, however, Deutman and coworkers [22], in the same period, hypothesized that it is a disease primarily affecting the choriocapillaris; therefore, they suggested the name acute multifocal ischemic choroidopathy (AMIC). This last term seems to be more proper as multimodal imaging has demonstrated [9].…”

Section: Primary Choriocapillaritis 31 Acute Posterior Multifocal Pla...mentioning

confidence: 99%

“…Ampiginous choroiditis is an uncommon variant that overlap features of both APMPPE/AMIC and SC [9]. It is characterized by chronic and recurrent clinical course as SC unlike APMPPE/AMIC.…”

Section: Relentless Placoid Chorioretinitis (Rpc)/ampiginous Choroidi...mentioning

confidence: 99%

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Multimodal Imaging of White Dot Syndromes

Santos¹,

Cocho²,

Herreras³

2023

Eye Diseases - Recent Advances, New Perspectives and Therapeutic Options

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White dot syndromes are an uncommon group of posterior uveitis affecting the outer retina, retinal pigment epithelium, choriocapillaris, and/or choroidal stroma. Multimodal imaging, including fundus fluorescein angiography, indocyanine green angiography, autofluorescence, and optical coherence tomography angiography, has improved our understanding regarding their pathophysiology, helping us to rename or even regroup some of these disorders as one disease in opposition to the historical description. It also provides useful information to evaluate disease activity and monitor response to treatment. This chapter will review the different findings on multimodal imaging of these heterogenous disorders and classify them according to their primary anatomic involvement.

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Section: Primary Choriocapillaritis 31 Acute Posterior Multifocal Pla...mentioning

confidence: 77%

Section: Primary Stromal Choroiditis With Additional Independent Reti...mentioning

confidence: 98%

Section: Primary Choriocapillaritis 31 Acute Posterior Multifocal Pla...mentioning

confidence: 99%

“…Ampiginous choroiditis is an uncommon variant that overlap features of both APMPPE/AMIC and SC [9]. It is characterized by chronic and recurrent clinical course as SC unlike APMPPE/AMIC.…”

Section: Relentless Placoid Chorioretinitis (Rpc)/ampiginous Choroidi...mentioning

confidence: 99%

See 2 more Smart Citations

Multimodal Imaging of White Dot Syndromes

Santos¹,

Cocho²,

Herreras³

2023

Eye Diseases - Recent Advances, New Perspectives and Therapeutic Options

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“…Beside these welldefined phenotypes, overlapping and intermediary forms, as well as mixed forms having the aspect of one entity with the evolution of another, are completing the spectrum. For more than two decades, these conditions were classified with other unrelated syndromes in the potpourri group of "white dot syndromes" [2,3]. On the reverse, PICCPs have a common denominator, choriocapillaris non-perfusion.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Treatment of Primary Inflammatory Choriocapillaropathies (PICCPs): A Comprehensive Overview

Papasavvas¹,

Herbort²

2022

Medicina

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Purpose: Primary inflammatory choriocapillaropathies (PICCPs) belong to a group of intraocular inflammatory diseases with the common characteristic of inflammatory choriocapillaris hypo- or non-perfusion as the main clinicopathological mechanism. The purpose of our article is to describe clinical characteristics and multimodal imaging, that can help the diagnosis and treatment of PICCPs. Methods: Narrative review with multimodal imaging analysis. Results: Choriocapillaris non-perfusion can affect the end-choriocappilaries, at the benign end of the PICCP spectrum (MEWDS), to larger choriocapillaris vessels or precapillary vessels at the origin of more severe forms such as acute posterior multifocal placoid pigment epitheliopathy (APMPPE), idiopathic multifocal choroiditis (MFC) and Serpiginous Choroiditis (SC). Diagnosis is mostly based on multimodal imaging and especially on indocyanine green angiography (ICGA), fundus autofluorescence (FAF) and spectral-domain optical coherence tomography (SD-OCT)/OCT-angiography (OCT-A). ICGA shows the typical pattern of patchy lobular hypofluorescence reflecting hypo- or non-perfusion of the choriocapillaris that can also take the aspect of geographic areas in the more severe forms. Treatment depends on the severity of the disease and goes from observation in MEWDS and some mild cases of APMPPE, to oral corticosteroid and/or immunomodulator agents in the more severe conditions of APMPPE and MFC and SC cases. Close multimodal monitoring is crucial in order to introduce or adjust treatment. Conclusion: PICCPs are resulting from one common clinicopathological mechanism, inflammatory choriocapillaris hypo- or non-perfusion. ICGA findings are essential for the diagnosis and follow-up of PICCPs, but non-invasive methods such as FAF and SD-OCT/OCT-A also have their role especially in follow-up of the diseases. Treatment should be individualized according to the pathology and the evolution of lesions.

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