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Clinical science
Multimodal imaging findings in ‘hyper-early’ stage MEWDS
  1. Armelle Cahuzac1,
  2. Benjamin Wolff1,
  3. Thibaud Mathis2,
  4. Marie-Hélène Errera3,
  5. José-Alain Sahel1,
  6. Martine Mauget-Faÿsse1
  1. 1Fondation Ophtalmologique Adolphe de Rothschild (FOR), 25 rue Manin, Paris Cedex 19, Île-de-France, France
  2. 2Service d'Ophtalmologie de l'Hôpital de la Croix-Rousse, 103 Grand rue de la Croix-Rousse, Lyon, Rhône-Alpes, France
  3. 3Centre Hospitalier National d'Ophtalmologique des Quinze-Vingts, Paris, France
  1. Correspondence to Armelle Cahuzac, Fondation Ophtalmologique Adolphe de Rothschild, 25 rue Manin, 75940 Paris Cedex 19, France; a.cahuzac{at}gmail.com

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

https://doi.org/10.1136/bjophthalmol-2016-309175

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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.