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Yasser Elshatory, Mahajan Vinit, James C Folk; Seasonality of the white dot syndromes. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3127.
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© ARVO (1962-2015); The Authors (2016-present)
While seasonality is a well-known attribute of human viral infections, especially enteric and respiratory viruses, it is unknown whether there is a seasonality component to the white dot syndromes, which are frequently hypothesized to have a viral etiology. To evaluate this, we assessed the timing of signs and symptoms associated with these conditions to evaluate for seasonality patterns. We performed a retrospective review of patients with white dot syndromes to assess the month of the year they initially experienced symptoms.
A retrospective chart review was performed of patients presenting to the vitreoretinal service at a tertiary referral center within the Midwest. Patients had various white dot syndromes. A photography database was used to identify diagnosis-specific cases, and those cases were evaluated for clearly identifiable dates of symptom onset.
Eighty seven charts of patients with acute multifocal placoid pigment epitheliopathy, punctate inner choroidopathy, serpiginous choroidopathy, acute zonal occult outer retinopathy, or multifocal choroiditis were reviewed; of which, forty five cases had clearly identifiable dates of onset. The majority of these cases presented during the fall (n=30), followed by the summer (n=21). Fewer cases presented during the spring (n=12), and winter (n=6). The seasonal index (the number of cases in a month divided by the average number of cases across all months) varied from1.87 in November to 0.27 in January. A test for seasonality supported a strong seasonal component to the white dot syndromes (p<0.0001).
White dot syndrome have a strong seasonal predilection towards fall and summer months over spring and winter months. This finding may suggest viral pathogens that more frequently present during fall and summer months may underlie these conditions. Reproducing this finding in prospective series of white dot syndromes would further support such as conclusion.<br />
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