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多發輝閃性白點症候群－12病例報告
Multiple Evanescent White Dot Syndrome-A Report of Twelve Cases
摘要
多發輝閃性白點症候群(multiple evanescent white dot syndrome)主要的特徵為急性單側視力減退及視網膜出現許多界限分明的黃白色小點。本篇蒐集了12例，其中女性10位，男性2位，平均年齡30.1歲．病患的主訴有單側眼視力模糊、出現有閃光或有黑點等徵狀，而初次就診的視力自6/6至2/60不等。有5位患者有類似感冒的前驅徵狀。在此12個病例中，有1位其mycoplasma pneumonia PA titer positive，1位為Rubella IgM positive，1位為血清中IgG及IgM升高，1位則為IgG及IgA升高，另有1位是IgM些微升高。有9位顯示出盲點擴大(enlargement of blind spot )的現象，另外1往則為centrocecal scotoma。有10位患者其網膜上的小白點於發生後2-9周消失且視力功能也得到良好的恢復，並與其他後遺症。但有2位患者因為視網膜小凹出血及出現顆粒狀變化，其視網膜上的白點消失後，視力並沒有明顯的改善。
關鍵字
無資料並列摘要
Multiple evanescent white dot syndrome (MEWDS) is characterized by monocular acute onset of temporal or paracentral scotoma accompanied by photopsia associated with multiple white dots lesions in retina. From January 1987 to July 1999, 12 cases with the diagnosis of MEWDS were reviewed. Ten patients were women and two were men with average age of 30.1 years. Patients complained of unilateral dimmed vision, flash of light, or dark spots in their vision, with an initial visual acuity of 6/6 to 2/60. Five patients had preceding flu-like illness. Among the twelve cases, it is noteworthy that one case was mycoplasma pneumonia PA titer positive, one was rubella 1gM positive, one was serum IgG and 1gM elevated, one was IgG and IgA elevated, and the other was 1gM mildly elevated. The visual field of nine patients showed enlargement of blind spots and one showed centrocecal scotoma. It is interesting that the visual field of one case demonstrated scattered scotomata somewhat corresponding to the white dots lesion in the retina as revealed by Humphrey perimetry. Ten patients had good recovery of visual acuity with eventual fading of the white dots in 2-9 weeks and without sequelae. Because of foveal granularity and foveal hemorrhage, the visual acuity of two cases did not improve well after fading of the white dots.