Armelle Cahuzac1, Benjamin Wolff1, Thibaud Mathis2, Marie-Hélène Errera3, José-Alain Sahel1, Martine Mauget-Faÿsse1. 1. Fondation Ophtalmologique Adolphe de Rothschild (FOR), 25 rue Manin, Paris Cedex 19, Île-de-France, France. 2. Service d'Ophtalmologie de l'Hôpital de la Croix-Rousse, 103 Grand rue de la Croix-Rousse, Lyon, Rhône-Alpes, France. 3. Centre Hospitalier National d'Ophtalmologique des Quinze-Vingts, Paris, France.
Abstract
OBJECTIVE: To describe a new stage of multiple evanescent white dot syndrome (MEWDS), occurring at a very early phase of the disease. METHODS: Retrospective analysis of clinical, angiographic and tomographic findings in four patients with 'hyper-early' stage MEWDS. RESULTS: In four patients seen within 1 week of the onset of symptoms, fundus analysis revealed macular granity and the classic yellow-white dots, some having no corresponding hyperautofluorescent pattern. Spectral-domain optical coherence tomography (SD-OCT) showed central foveal disruption of the ellipsoid zone (EZ) and interdigitation layer with a hyper-reflective dome-shaped lesion. In two patients, fluorescein angiography (FA) revealed an intermediate hypofluorescent perimacular halo, whereas late indocyanine green angiography (ICGA) showed a hyperfluorescent halo as well as the classic MEWDS features. After a few days, the EZ disruption appeared complete on OCT and fundus autofluorescence (FAF) in all patients. Visual acuity, OCT and FAF findings had fully recovered within 3 months. CONCLUSIONS: We have shown a new feature of MEWDS on FAF, OCT, FA and ICGA, corresponding to a very early stage of the disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
OBJECTIVE: To describe a new stage of multiple evanescent white dot syndrome (MEWDS), occurring at a very early phase of the disease. METHODS: Retrospective analysis of clinical, angiographic and tomographic findings in four patients with 'hyper-early' stage MEWDS. RESULTS: In four patients seen within 1 week of the onset of symptoms, fundus analysis revealed macular granity and the classic yellow-white dots, some having no corresponding hyperautofluorescent pattern. Spectral-domain optical coherence tomography (SD-OCT) showed central foveal disruption of the ellipsoid zone (EZ) and interdigitation layer with a hyper-reflective dome-shaped lesion. In two patients, fluorescein angiography (FA) revealed an intermediate hypofluorescent perimacular halo, whereas late indocyanine green angiography (ICGA) showed a hyperfluorescent halo as well as the classic MEWDS features. After a few days, the EZ disruption appeared complete on OCT and fundus autofluorescence (FAF) in all patients. Visual acuity, OCT and FAF findings had fully recovered within 3 months. CONCLUSIONS: We have shown a new feature of MEWDS on FAF, OCT, FA and ICGA, corresponding to a very early stage of the disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Authors: Felipe Pereira; Luiz H Lima; Alexandre Gomes B de Azevedo; Claudio Zett; Michel E Farah; Rubens Belfort Journal: J Ophthalmic Inflamm Infect Date: 2018-10-13