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VOLUME 16 , ISSUE 2 ( April, 2023 ) > List of Articles

Síndrome de Puntos Blancos: La Importancia de las Imágenes

Milagros Heredia, Juliana Montoya, C. Stephanie Alanez Claure, N. Carolina Vanegas Trejo, Luz M. De Zavalía Stordeur, Paula Aquino, Andrés F. Lasave, B. Ariel Schlaen

Keywords : Síndrome de puntos blancos, uveítis posterior, coriocapilaritis, coroiditis, síndrome de múltiples puntos blancos evanescentes, epiteliopatía pigmentaria placoidea multifocal posterior aguda, coroiditis serpiginosa, coroiditis multifocal con panuveítis, coroiditis punctata interna, coriorretinopatía en perdigonada, retinopatía externa oculta zonal aguda, SD OCT, EDI OCT, ICG, angiografía con fluoresceína, autofluorescencia, angiografía por OCT

Citation Information : Heredia M, Montoya J, Claure CS, Trejo NC, Stordeur LM, Aquino P, Lasave AF, Schlaen BA. Síndrome de Puntos Blancos: La Importancia de las Imágenes. 2023; 16 (2):4-33.

DOI: 10.5005/hov-10102-16201

Published Online: 01-06-2023

Copyright Statement:  Copyright © 2023; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Objetivo: Describir las características distintivas en los estudios de imágenes de algunas de las enfermedades comprendidas dentro del grupo de los síndromes de puntos blancos (SPB) y el impacto de las mismas sobre su nueva clasificación. Antecedentes: El grupo de enfermedades comúnmente reconocidas que constituyen el SPB incluyen: • Síndrome de múltiples puntos blancos evanescentes (MEWDS, Multiple Evanescent White Dot Syndrome), • Epiteliopatía pigmentaria placoide multifocal posterior aguda (APMPPE, Acute Posterior Multifocal Placoid Pigment Epitheliopathy), • Coroiditis multifocal con panuveitis (CMP) • Coroidopatía punctata interna (PIC, Punctate Inner Choroidopathy), • Retinopatía externa oculta zonal aguda (AZOOR, Acute Zonal Occult Outer Retinopathy), • Coriorretinopatía en perdigonada (CRP), • Coroidopatía serpiginosa (CS) Los aportes de los estudios complementarios emergentes de la época han generado que numerosas publicaciones actuales tiendan a considerar que la denominación “Síndromes de Puntos Blancos” no tenga un aval absoluto y se considere una generalización imprecisa de estas patologías, siendo necesaria una nueva denominación en función de su fisiopatogenia. Resultados: MEWDS, APMPPE, CMP, PIC, AZOOR, CRP y CS, son enfermedades que difieren en cuanto a su patogenia, presentación, evolución, pronóstico y tratamiento. Es por esto, que el término “síndrome de puntos blancos” ha quedado desactualizado, haciendo necesaria su correcta denominación como “coriocapilaritis” y “enfermedades del estroma coroideo”. Mientras la mayoría de ellas se originan en una inflamación de la red capilar de la coroides, la CRP es una coroiditis estromal, y el AZOOR una inflamación que compromete los fotorreceptores como lesión primaria. Conclusión: Las imágenes multimodales han permitido conocer con mayor profundidad la patogenia y el compromiso estructural del grupo de enfermedades conocidas como síndromes de puntos blancos. Esto ha derivado en una mayor comprensión de este grupo de enfermedades de baja incidencia.


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