Inflammatory chorioretinopathies (White Dot Syndromes), diagnosis and management: A review of the literature
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Abstract
Background: The white dot syndromes or inflammatory chorioretinopathies are a heterogenous group of diseases of unknown aetiology, characterized by the appearance of white dots on the fundus. These group of disorders include, acute posterior multifocal placoid pigment epitheliopathy (APMPPE), serpiginous choroiditis, multiple evanescent white dot syndrome (MEWDS), multifocal choroiditis and panuveitis (MCP), punctate inner choroidopathy (PIC), and diffuse subretinal fibrosis (DSF). They appear to have similar modes of presentation, but subtle differences noted help in their diagnosis coupled with and imaging techniques aids in the management of these disorders.
Aim: This study aims to review relevant literature available on inflammatory chorioretinopathies, their diagnosis and management.
Methods: Review of pertinent literature and available publications using the terms ‘White Dot Syndrome (WDS)’, ‘inflammatory chorioretinopathies’ acute multifocal placoid punctate epitheliopathy, birdshot chorioretinopathy, serpiginous choroiditis, multifocal choroiditis and panuveitis and punctate inner choroiditis were sought for using a comprehensive literature search of PubMed and MEDLINE. All relevant articles, full length and abstract that had information on clinical presentations, investigations and available
treatment modalities were included. Additional papers were also selected from reference lists of papers identified by the electronic database search.
Results: Reviewed information shows that the WDS though similar in presentation are still considered to be separate disease entities and not really a spectrum of the same disease as some postulate. Most are self-limiting and visual prognosis is generally good. Newer treatment modalities uncovered in this review include the use of intravitreal anti-vascular endothelial growth factors in the treatment of sight-threatening complications such as choroidal neovascularisation.
Conclusion: This article has reviewed inflammatory chorioretinopathies or WDS as reported in literature over 4 decades. An appreciable data exist and reviewed information reveals that WDS are a heterogeneous group of disorders with similar aetiology and modes of presentation but with some subtle distinct characteristics. Further studies on predictors of foveal involvement would inform what prophylactic treatments maybe beneficiary in preventing visual loss.
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