PT  - JOURNAL ARTICLE
AU  - Armelle Cahuzac
AU  - Benjamin Wolff
AU  - Thibaud Mathis
AU  - Marie-Hélène Errera
AU  - José-Alain Sahel
AU  - Martine Mauget-Faÿsse
TI  - Multimodal imaging findings in ‘hyper-early’ stage MEWDS
AID  - 10.1136/bjophthalmol-2016-309175
DP  - 2017 Oct 01
TA  - British Journal of Ophthalmology
PG  - 1381--1385
VI  - 101
IP  - 10
4099  - http://bjo.bmj.com/content/101/10/1381.short
4100  - http://bjo.bmj.com/content/101/10/1381.full
SO  - Br J Ophthalmol2017 Oct 01; 101
AB  - 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.