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November 2001

Overlap Among Acute Idiopathic Blind Spot Enlargement Syndrome and Other Conditions

Arch Ophthalmol. 2001;119(11):1729-1730. doi:

Volpe et al1 retrospectively reviewed the records of 27 women at 2 institutions who were diagnosed as having unilateral acute idiopathic blind spot enlargement syndrome (AIBSE). The patients were referred by comprehensive ophthalmologists or retinal specialists because a diagnosis could not be established. No information was provided concerning the interval between the onset of symptoms and the authors' examination. Each patient had a history of acute onset of visual disturbance, and each had demonstrable blind spot enlargement (BSE) in 1 eye on visual field testing. The BSE was not caused by optic disc swelling. Although no other criteria for patient recruitment or exclusion were given, the 100% unilateral involvement in women suggests that sex and unilaterality may have been factors. Less than half of the patients had fundus photographs or fluorescein angiography. Only one third had either full-field electroretinography (ERG), focal ERG, or both. One patient had a normal focal ERG result that seemed incompatible with receptor cell damage in the juxtapapillary region. Only 10 (37%) of the patients had follow-up, and for an unstated length of time. The authors concluded that the striking predilection for the peripapillary retina distinguishes AIBSE from multiple evanescent white dot syndrome (MEWDS) and that unlike patients with MEWDS, recovery of the visual field does not occur in patients with AIBSE. They further concluded that AIBSE is a nonprogressive condition that is distinct from MEWDS, acute zonal occult outer retinopathy (AZOOR), acute macular neuroretinopathy (AMN), and multifocal choroiditis with panuveitis.