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Choroidal neovascularisation triggered multiple evanescent white dot syndrome (MEWDS) in predisposed eyes
  1. Thibaud Mathis1,
  2. Benoit Delaunay1,
  3. Armelle Cahuzac2,
  4. Vivien Vasseur2,
  5. Martine Mauget-Faÿsse2,
  6. Laurent Kodjikian1
  1. 1Department of Ophthalmology, Croix-Rousse University Hospital, University of Lyon, Lyon, France
  2. 2Department of Vitreo-retinal Surgery, Rothschild Ophthalmologic Foundation, Paris, France
  1. Correspondence to Dr Thibaud Mathis, Department of Ophthalmology, Croix-Rousse University Hospital, Lyon, France; mathisthibaud{at}hotmail.fr

Abstract

Background Multiple evanescent white dot syndrome (MEWDS) is an inflammatory disease that can be associated with choroidalneovascularisation (CNV). However, few studies in the literature have described the occurrence of MEWDS in association with CNV. This paper discusses whether CNV can trigger MEWDS in a predisposed eye.

Methods A retrospective multicentric case series of six eyes in six patients with acute onset of MEWDS and evidence of previous CNV was conducted between January 2015 and January 2017. All patients underwent ophthalmic examination including multimodal imaging at baseline and during follow-up.

Results The mean age was 32.2±12.2 years. The majority of patients were women (5/1). In each case, MEWDS was diagnosed during a recurrence or occurrence of CNV secondary to choriocapillaritis, central serous chorioretinopathy or atrophic scar, presumably due to congenital toxoplasmosis. All patients were treated with intravitreal injections of antivascular endothelial growth factor (anti-VEGF) with good anatomical and functional responses (mean gain of 0.3±0.31 logMAR). The mean duration of follow-up was 13.5±10.65 months.

Conclusion This study highlights a sequence in the development of MEWDS, following the occurrence or recurrence of CNV. CNV may trigger MEWDS, possibly due to the proinflammatory environment created by the retinal tissue surrounding the CNV.

  • inflammation
  • imaging
  • neovascularisation
  • retina

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Footnotes

  • Contributors TM: original idea for the article, literature search, acquisition and analysis of data, writing the article and final approval of the version to be published. BD: acquisition and analysis of data, literature search and final approval of the version to be published. AC: acquisition and analysis of data, and final approval of the version to be published. VV: acquisition and analysis of data, and final approval of the version to be published. MM-F: designing, critical revision and final approval of the work. LK: designing, critical revision and final approval of the work.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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