Inflammatory Maculopathies
摘要
White dot syndromes (WDS) represent a group of inflammatory disorders affecting the outer retina, retinal pigment epithelium (RPE), and choroid. This chapter provides a comprehensive review of major WDS entities, including placoid diseases, birdshot-type retinochoroiditis, multifocal choroiditis, punctate inner choroidopathy, and multiple evanescent white dot syndrome. The placoid diseases discussed include acute posterior multifocal placoid pigment epitheliopathy (APMPPE), persistent placoid maculopathy (PPM), chronic placoid chorioretinitis (CPC), and idiopathic serpiginous choroiditis (ISC). Each condition is characterized by distinct clinical presentations, imaging findings, and treatment approaches. While some conditions, like MEWDS, typically resolve spontaneously with excellent prognosis, others, such as birdshot retinochoroiditis and multifocal choroiditis, may require aggressive immunosuppressive therapy. The chapter emphasizes the importance of multimodal imaging, including fluorescein angiography, indocyanine green angiography, optical coherence tomography, and fundus autofluorescence in diagnosis and monitoring. In regions where infectious diseases are prevalent, conditions like syphilis and tuberculosis must be excluded before establishing a WDS diagnosis. Understanding these distinct entities is crucial for appropriate management and optimal visual outcomes.