Article Text
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.
- Retina
- Imaging
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Footnotes
Contributors AC: original idea for the article; literature search; acquisition and analysis of data; final approval of the version to be published; guarantor. BW: original idea for the article; design of the work; acquisition and analysis of data; critical revising of the work; final approval of the version to be published. TM: literature search; acquisition and analysis of data; final approval of the version to be published. M-HE: acquisition and analysis of data; critical revising of the work; final approval of the version to be published. J-AS: design of the work; critical revising of the work; final approval of the version to be published. MM-F: design of the work; writing of the article; critical revising of the work; final approval of the version to be published.
Competing interests None declared.
Ethics approval Comité d'Ethique de la Fondation Rothschild.
Provenance and peer review Not commissioned; externally peer reviewed.