Expanded clinical spectrum of multiple evanescent white dot syndrome with multimodal imaging

Marcela Marsiglia, Roberto Gallego-Pinazo, Eduardo Cunha De Souza, Marion R. Munk, Suquin Yu, Sarahmd Mrejen, Emmett T. Cunningham, Brandon J. Lujan, R. Goldberg Naomi, Thomas A. Albini, Alain Gaudric, Catherine Francais, Richard B. Rosen, K. Bailey Freund, Lee M. Jampol, Lawrence A. Yannuzzi

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

Purpose: To evaluate and characterize multiple evanescent white dot syndrome abnormalities with modern multimodal imaging modalities. Methods: This retrospective cohort study evaluated fundus photography, fluorescein angiography, indocyanine green angiography, optical coherence tomography, enhanced depth imaging optical coherence tomography, short-wavelength autofluorescence, and near-infrared autofluorescence. Results: Thirty-four multiple evanescent white dot syndrome patients with mean age of 28.7 years were studied (range, 14-49 years). Twenty-six patients were women, and eight were men. Initial mean visual acuity was 0.41 logMAR. Final mean visual acuity was 0.03 logMAR. Fluorescein angiography shows a variable number of mid retinal early fluorescent dots distributed in a wreathlike pattern, which correlate to fundus photography, fundus autofluorescence, and indocyanine green angiography. Indocyanine green angiography imaging shows the dots and also hypofluorescent, deeper, and larger spots, which are occasionally confluent, demonstrating a large plaque of deep retinal hypofluorescence. Optical coherence tomography imaging shows multifocal debris centered at and around the ellipsoid layer, corresponding to the location of spots seen with photography, indocyanine green angiography, and fluorescein angiography. Protrusions of the hyperreflectant material from the ellipsoid layer toward the outer nuclear layer correspond to the location of dots seen with photography, indocyanine green angiography, and fluorescein angiography. Conclusion: Multimodal imaging analysis of the retina in patients with multiple evanescent white dot syndrome shows additional features that may help in the diagnosis of the disease and in further understanding its etiology. Multiple evanescent white dot syndrome is predominantly a disease of the outer retina, centered at the ellipsoid zone, but also involving the interdigitation zone and the outer nuclear layer.

Original languageEnglish (US)
Pages (from-to)64-74
Number of pages11
JournalRetina
Volume36
Issue number1
DOIs
StatePublished - Jan 1 2016

Keywords

  • Autofluorescence
  • Fluorescein angiography
  • Indocyanine green angiography
  • MEWDS
  • Multimodal imaging
  • Multiple evanescent white dot syndrome
  • Optical coherence tomography
  • Posterior uveitis
  • Retina
  • Uveitis

ASJC Scopus subject areas

  • Ophthalmology

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  • Cite this

    Marsiglia, M., Gallego-Pinazo, R., De Souza, E. C., Munk, M. R., Yu, S., Mrejen, S., Cunningham, E. T., Lujan, B. J., Naomi, R. G., Albini, T. A., Gaudric, A., Francais, C., Rosen, R. B., Freund, K. B., Jampol, L. M., & Yannuzzi, L. A. (2016). Expanded clinical spectrum of multiple evanescent white dot syndrome with multimodal imaging. Retina, 36(1), 64-74. https://doi.org/10.1097/IAE.0000000000000685