An atypical white dot syndrome after traumatic subretinal hemorrhage

Retin Cases Brief Rep. 2012 Fall;6(4):339-44. doi: 10.1097/ICB.0b013e318260af4a.

Abstract

Purpose: The purpose of this report was to describe a case of an atypical white dot syndrome that developed 10 weeks after a traumatic subretinal hemorrhage.

Methods: Retrospective chart review.

Results: A 24-year-old woman presented 2 days after being punched in her right eye. A subretinal hemorrhage was present along the inferotemporal vascular arcades of the affected eye. The hemorrhage was slowly resolving until 10 weeks later when the patient noticed a new superonasal scotoma and floaters in her right eye. Deep retinal and retinal pigment epithelial gray-white spots were present inferotemporally around the hemorrhage. These spots were identifiable on fundus autofluorescence photography, fluorescein angiography, and indocyanine green angiography. A subretinal inflammatory mass was identified adjacent to the subretinal hemorrhage. In addition, there was mild vitritis, acute papillitis, retinal vasculitis, and photoreceptor disruption visible on spectral domain optical coherence tomography. The patient was started on oral prednisone with subsequent improvement in signs and symptoms.

Conclusion: Ocular trauma with subretinal hemorrhage may induce a white dot syndrome sharing some features with Multiple Evanescent White Dot Syndrome and Multiocal Choroiditis and Panuveitis.