Acute idiopathic blind spot enlargement syndrome in a patient with high myopia : A case report with multimodal imaging findings
- 1Ophthalmology & Optometry Medical School, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
- 2Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
- 3Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Shandong Academy of Eye Disease Prevention and Therapy, and Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Jinan, Shandong Province, China.
Abstract
Rationale:: To report the clinical manifestations, multimodal imaging features, and treatment outcomes of a case of acute idiopathic blind spot enlargement syndrome (AIBSES) in a patient with high myopia.
Patient concerns:: A 47-year-old male with high myopia presented with sudden visual field (VF) obscuration and photopsia in the left eye, with best-corrected visual acuity of 0.05 in the affected eye at initial examination.
Diagnoses:: Based on characteristic VF findings showing diffuse central sensitivity depression with a temporal defect contiguous with the physiological blind spot, optical coherence tomography (OCT) showing heterogeneous reflectivity of the neurosensory retina and focal discontinuity of the ellipsoid zone (EZ) signal, and multifocal electroretinography demonstrating reduced P1 response amplitude density across all 5 tested rings, a diagnosis of AIBSES was established.
Interventions:: The patient received systemic corticosteroid therapy, followed by additional pharmacologic treatment and adjunctive acupuncture at the 4-month follow-up.
Outcomes:: At the 7‑month follow‑up, best-corrected visual acuity improved from 0.05 to 0.2, with substantial improvement in the VF defect and gradual restoration of EZ continuity on OCT. Because spontaneous recovery is recognized in AIBSES, the observed improvement cannot be attributed solely to corticosteroid therapy.
Lessons:: AIBSES is an outer retinopathy characterized by acute VF defects, photopsia, and outer retinal structural abnormalities, with visual dysfunction that may be disproportionate to relatively subtle fundoscopic findings. Characteristic VF defects and EZ disruption on OCT are important diagnostic features. AIBSES should be considered in patients presenting with acute visual decline or VF defects but minimal fundus abnormalities to avoid misdiagnosis as optic neuritis or other disorders. In patients with high myopia, myopia-related structural and functional alterations may influence the interpretation of ancillary examinations; therefore, comprehensive evaluation based on multimodal imaging and electrophysiological assessments is essential.
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BibTeX
@article{liu2026acute,
title = {{Acute idiopathic blind spot enlargement syndrome in a patient with high myopia : A case report with multimodal imaging findings}},
author = {Hanzhi Liu and Zhengfeng Liu and Qiuxin Wu and Yifei Yang and Xuemei Pan},
journal = {Medicine},
year = {2026},
month = oct,
doi = {10.1097/md.0000000000051426},
url = {https://europepmc.org/article/PMC/PMC13727213},
note = {CC BY},
}
RIS
TY - JOUR
TI - Acute idiopathic blind spot enlargement syndrome in a patient with high myopia : A case report with multimodal imaging findings
AU - Hanzhi Liu
AU - Zhengfeng Liu
AU - Qiuxin Wu
AU - Yifei Yang
AU - Xuemei Pan
PY - 2026
DA - 2026/10/30
JO - Medicine
DO - 10.1097/md.0000000000051426
UR - https://europepmc.org/article/PMC/PMC13727213
AB - Rationale:: To report the clinical manifestations, multimodal imaging features, and treatment outcomes of a case of acute idiopathic blind spot enlargement syndrome (AIBSES) in a patient with high myopia. Patient concerns:: A 47-year-old male with high myopia presented with sudden visual field (VF) obscuration and photopsia in the left eye, with best-corrected visual acuity of 0.05 in the affected eye at initial examination. Diagnoses:: Based on characteristic VF findings showing diffuse central sensitivity depression with a temporal defect contiguous with the physiological blind spot, optical coherence tomography (OCT) showing heterogeneous reflectivity of the neurosensory retina and focal discontinuity of the ellipsoid zone (EZ) signal, and multifocal electroretinography demonstrating reduced P1 response amplitude density across all 5 tested rings, a diagnosis of AIBSES was established. Interventions:: The patient received systemic corticosteroid therapy, followed by additional pharmacologic treatment and adjunctive acupuncture at the 4-month follow-up. Outcomes:: At the 7‑month follow‑up, best-corrected visual acuity improved from 0.05 to 0.2, with substantial improvement in the VF defect and gradual restoration of EZ continuity on OCT. Because spontaneous recovery is recognized in AIBSES, the observed improvement cannot be attributed solely to corticosteroid therapy. Lessons:: AIBSES is an outer retinopathy characterized by acute VF defects, photopsia, and outer retinal structural abnormalities, with visual dysfunction that may be disproportionate to relatively subtle fundoscopic findings. Characteristic VF defects and EZ disruption on OCT are important diagnostic features. AIBSES should be considered in patients presenting with acute visual decline or VF defects but minimal fundus abnormalities to avoid misdiagnosis as optic neuritis or other disorders. In patients with high myopia, myopia-related structural and functional alterations may influence the interpretation of ancillary examinations; therefore, comprehensive evaluation based on multimodal imaging and electrophysiological assessments is essential.
SN - 0304-5412
SN - 1536-5964
SN - 0025-7974
ER -