Chiara Veronese1, Chiara Maiolo2, Mariachiara Morara3, Grayson W Armstrong4, Antonio P Ciardella3. 1. Ophthalmology Unit, S. Orsola-Malpighi Hospital, University of Bologna, Via Pelagio Palagi 9, 40138, Bologna, Italy. chveronese@yahoo.com. 2. University of Bologna, Bologna, Italy. 3. Ophthalmology Unit, S. Orsola-Malpighi Hospital, University of Bologna, Via Pelagio Palagi 9, 40138, Bologna, Italy. 4. Ophthalmology Department, Massachusetts Eye and Ear Infirmary/Harvard Medical School, Boston, MA, USA.
Abstract
PURPOSE: To present a single case of bilateral multiple evanescent white dot syndrome (MEWDS). METHODS: A single case with three months of follow-up using imaging studies including fundus color photography (FP), fluorescein angiography (FA), indocyanine green angiography (ICGA), fundus autofluorescence (FAF), spectral-domain optical coherence tomography (SD-OCT), en face SD-OCT and optical coherence tomography angiography (OCTA) is presented. RESULTS: The patient presented with bilateral MEWDS, ultimately with complete resolution of symptoms. FP revealed foveal granularity and white punctate deep retinal spots, FA found early wreath-like hyperfluorescence, while ICGA showed hypofluorescent dots and spots in the early and late stages. FAF showed areas of hyperautofluorescence. SD-OCT revealed disruption of the ellipsoid zone (EZ) and accumulation of hyperreflective material of variable size and shape. En face SD-OCT demonstrated hyporeflective areas corresponding to areas of EZ disruption as well as hyperreflective dots in the outer nuclear layer. OCTA showed areas of photoreceptor slab black-out corresponding to areas of EZ disruption and light areas of flow void or flow disturbance in the choriocapillaris slab. CONCLUSIONS: This case represents an unusual case of bilateral MEWDS with complete resolution within three months.
PURPOSE: To present a single case of bilateral multiple evanescent white dot syndrome (MEWDS). METHODS: A single case with three months of follow-up using imaging studies including fundus color photography (FP), fluorescein angiography (FA), indocyanine green angiography (ICGA), fundus autofluorescence (FAF), spectral-domain optical coherence tomography (SD-OCT), en face SD-OCT and optical coherence tomography angiography (OCTA) is presented. RESULTS: The patient presented with bilateral MEWDS, ultimately with complete resolution of symptoms. FP revealed foveal granularity and white punctate deep retinal spots, FA found early wreath-like hyperfluorescence, while ICGA showed hypofluorescent dots and spots in the early and late stages. FAF showed areas of hyperautofluorescence. SD-OCT revealed disruption of the ellipsoid zone (EZ) and accumulation of hyperreflective material of variable size and shape. En face SD-OCT demonstrated hyporeflective areas corresponding to areas of EZ disruption as well as hyperreflective dots in the outer nuclear layer. OCTA showed areas of photoreceptor slab black-out corresponding to areas of EZ disruption and light areas of flow void or flow disturbance in the choriocapillaris slab. CONCLUSIONS: This case represents an unusual case of bilateral MEWDS with complete resolution within three months.
Entities:
Keywords:
Bilateral multiple evanescent white dot syndrome; En face SD-OCT; Fundus autofluorescence; OCTA
Authors: Marcela Marsiglia; Roberto Gallego-Pinazo; Eduardo Cunha de Souza; Marion R Munk; Suquin Yu; Sarah Mrejen; Emmett T Cunningham; Brandon J Lujan; Naomi R Goldberg; Thomas A Albini; Alain Gaudric; Catherine Francais; Richard B Rosen; K Bailey Freund; Lee M Jampol; Lawrence A Yannuzzi Journal: Retina Date: 2016-01 Impact factor: 4.256