Zespół ostrego idiopatycznego poszerzenia plamy ślepej – opis pacjenta
Acute Idiopathic Blind Spot Enlargement Syndrome (AIBSE) – Case Report
Wojciech Lubiński, Wojciech Gosławski, Ewelina Lachowicz, Małgorzata Kaczmarek
Katedra i Klinika Okulistyki Pomorskiego Uniwersytetu Medycznego w Szczecinie
Kierownik: dr hab. n. med. Wojciech Lubiński, prof. nadzw. PUM, FEBO
Summary: Purpose: To present an AIBSE in patient without associated systemic diseases.
Patient and Methods: A 33 years old female presented with a two weeks history of photopsias and scotoma in her right eye. Diagnostic tests included: visual acuity (VA), anterior segment and fundoscopy, automated perimetry SP-30-2 (W/W, B/Y), fluorescein angiography (FA), multifocal electroretinogram (MfERG), pattern visual evoked potential (PVEP) and flash electroretinogram (ERG).
Results: The VA on RE/ LE was equal 0.9-1.0 (Snellen chart). Intraocular pressure, anterior segment of both eyes and fundus of LE were normal. Impaired afferent response to light in the RE was detected. In the fundus of the RE mild temporal swelling of the optic nerve with associated dilated blood vessels and the retinal folds were seen. Additionally subtle degenerative changes were found in the foveola. In static perimetry SP-30-2 (W/W, B/Y) a blind spot enlargement was detected. In FA of the RE staining of dye on the optic nerve disc and in the retina directly surrounding optic disc was found. MfERG revealed dysfunction of cone system corresponding with the visual field defects seen in SP. Based on an interview, clinical picture and additional tests AIBSE was diagnosed. Confirmation of this diagnosis was 2 months follow-up of patient. In the control visit spontaneous improvement of visual acuity to 1.0 in RE was achieved. The dark spot was the only one complain of the patient. After temporal retinal edema remained only the subtle retinal atrophy.
Conclusion: In the differential diagnosis in young female with symptoms suggesting optic neuritis or migraine AIBSE should be taken into consideration. AIBSE diagnosis is very important because this disease should not be treated and the prognosis is relatively good.
Słowa kluczowe: zespół ostrego idiopatycznego poszerzenia plamy ślepej, angiografia fluoresceinowa, mfERG, ERG, PVEP, perymetria statyczna (W/W, B/Y).
Keywords: acute idiopathic blind spot enlargement, multiple evanescent white dot syndrome, fluorescein angiography, mfERG, ERG, PVEP, automatic perimetry (W/W, B/Y).