Wenyi Tang1, Jingli Guo1, Wei Liu2, Gezhi Xu1,3,4. 1. Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China. 2. Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China. bfgf14@aliyun.com. 3. Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China. 4. NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.
Abstract
PURPOSE: To describe optical coherence tomography angiography (OCTA) and other multimodal imaging features of multiple evanescent white dot syndrome (MEWDS). METHODS: The retinal and choriocapillary vascular density of MEWDS patients were measured by OCTA (OptoVue Inc.) in the acute and recovery phases. And other multimodal imaging data were also retrospectively reviewed. RESULTS: Sixteen patients with a mean age of 26.5 ± 6.99 years were included. Three patients were complicated with choroidal neovascularization (CNV). The mean baseline logMAR BCVA of the affected eyes was 0.52 ± 0.36 (Snellen equivalent 20/50). OCTA revealed significant reductions in vascular densities of deep capillary plexus (45.72 ± 3.70%, P = 0.0007), and choriocapillaris (46.08 ± 3.22%, P < 0.0001) of the affected eyes compared with the contralateral eyes (50.23 ± 4.06% and 52.28 ± 4.19%, respectively) in the acute phase. During the recovery phases, vascular densities of deep capillary plexus (49.50 ± 3.15%, P < 0.0001) and choriocapillaris (53.67 ± 2.58%, P < 0.0001) increased significantly in the affected eyes while those of the superficial capillary plexus remained stable. SD-OCT revealed an increase of the subfoveal choroidal thickness and disruption of the outer retinal layer, including ellipsoid zone discontinuities and the accumulation of hyperreflective material, corresponding to the hypofluorescent spots and dots on ICGA, respectively. BCVA increased to normal values after recovery, together with restoration of the structural morphology and choroidal thickness on SD-OCT, except in eyes with CNV. CONCLUSION: The inner retinal layer and choroid can be secondarily transiently compromised in MEWDS. MEWDS complicated with CNV is associated with worse visual outcomes.
PURPOSE: To describe optical coherence tomography angiography (OCTA) and other multimodal imaging features of multiple evanescent white dot syndrome (MEWDS). METHODS: The retinal and choriocapillary vascular density of MEWDS patients were measured by OCTA (OptoVue Inc.) in the acute and recovery phases. And other multimodal imaging data were also retrospectively reviewed. RESULTS: Sixteen patients with a mean age of 26.5 ± 6.99 years were included. Three patients were complicated with choroidal neovascularization (CNV). The mean baseline logMAR BCVA of the affected eyes was 0.52 ± 0.36 (Snellen equivalent 20/50). OCTA revealed significant reductions in vascular densities of deep capillary plexus (45.72 ± 3.70%, P = 0.0007), and choriocapillaris (46.08 ± 3.22%, P < 0.0001) of the affected eyes compared with the contralateral eyes (50.23 ± 4.06% and 52.28 ± 4.19%, respectively) in the acute phase. During the recovery phases, vascular densities of deep capillary plexus (49.50 ± 3.15%, P < 0.0001) and choriocapillaris (53.67 ± 2.58%, P < 0.0001) increased significantly in the affected eyes while those of the superficial capillary plexus remained stable. SD-OCT revealed an increase of the subfoveal choroidal thickness and disruption of the outer retinal layer, including ellipsoid zone discontinuities and the accumulation of hyperreflective material, corresponding to the hypofluorescent spots and dots on ICGA, respectively. BCVA increased to normal values after recovery, together with restoration of the structural morphology and choroidal thickness on SD-OCT, except in eyes with CNV. CONCLUSION: The inner retinal layer and choroid can be secondarily transiently compromised in MEWDS. MEWDS complicated with CNV is associated with worse visual outcomes.
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Keywords:
Choroidal neovascularization; Multimodal imaging; Multiple evanescent white dot syndrome; Optical coherence tomography angiography; Vascular density