Título / Title

OVERLAP OF ANGIOID STREAKS (AS) AND MULTIPLE EVANESCENT WHITE DOT SYNDROME (MEWDS): A CASE REPORT

Introdução / Purpose

AS are constituted by ruptures in Bruch's membrane and are characterized by brown or red lesions with irregular margins that radiate from the optic nerve. MEWDS is a self-limiting unilateral ocular inflammatory disease that occurs primarily in healthy, myopic young individuals. Symptoms usually resolve within weeks to months, with complete recovery of visual acuity.

Material e Método / Methods

Description of the case of a male patient, 41-year-old, complaining of low central visual acuity in the right eye with evolution of 15 days. He presented visual acuity 20/40. In the biomicroscopy, there was no anterior chamber reaction. However, it had a discrete vitreous tyndall. In the fundoscopy, the presence of white dots around the vascular arches to the equator was noticed, besides fine granulation in posterior pole of the right eye. There were radiating streaks around the optic nerve in both eyes.

Resultados / Results

In the SD-OCT examination, there was discontinuation of the perifoveal IS/OS. At the angiofluorosceinography , there was rosette hyperfluorescence in topography of white lesions. Expectant management was taken and the patient evolved with remission of symptoms. Right eye visual acuity was 20/20.

Discussão e Conclusões / Conclusion

We present a case of overlap between AS and MEWDS. Despite the good evolution of the condition with observation only, we know that both diseases present the potential to develop complications such as choroidal neovascularization (CNV). It is of clinical relevance to consider serpiginous choroiditis (SC) as a differential diagnosis in the case described. Peridiscal lesions are found in both AS and SC. SC represents a Multifocal choroiditis with outer retinal/choriocapillaris-based pathology. The RPE, choriocapillaris, and choroid are involved. The subsidiary exams and the favorable evolution only with clinical follow-up reinforce the diagnosis of AS.

Palavras Chave

Angioid streaks; multiple evanescent white dot syndrome; overlap syndrome; serpiginous choroiditis