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Characteristics of multiple evanescent white dot syndrome with multimodal imaging

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Author:
No author available
Journal Title:
Chinese Journal of Ocular Fundus Diseases
Issue:
3
DOI:
10.3760/cma.j.issn.1005-1015.2016.03.007
Key Word:
视网膜疾病/诊断;荧光素血管造影术;吲哚花青绿;体层摄影术,光学相干;诊断显像;Retinal diseases/diagnosis;Fluorescein angiography;Indocyanine green;Tomography,optical coherence;Diagnostic imaging

Abstract: Objective To observe the characteristics of multiple evanescent white dot syndrome (MEWDS) with modern multimodal imaging modalities.Methods This was a retrospective case study.Eleven patients (11 eyes) diagnosed with MEWDS were enrolled.There were 10 females and 1 male,mean age was 27.6 years (range 15-41 years).The period between disease onset and visiting to the hospital was between 2 to 13 days,the average time was 4.7 days.All the patients underwent examinations of best corrected visual acuity,slit-lamp biomicroscope,indirect ophthalmoscope,fundus color photography,fundus autofluorescence (FAF),fundus fluorescein angiography (FFA),indocyanine green angiography (ICGA) and spectral domain optical coherence tomography (SD-OCT).The mean follow up duration was 3.2 months.The imaging characteristics were compared.Results Fundus color photography showed foveal orange-red granularity in all eyes.FAF showed strong autofluorescence with a vague boundary.FFA showed a variable number of highly fluorescent fine needle-like dots arranged in a ring in the early stage,and fluorescence remained in the late stage.ICGA showed advanced lesions of vague boundary merged into a large plaque of deep retinal hypofluorescence.SD-OCT showed the hyperreflectant material deposit over the retinal pigment epithelium and extending anteriorly through the interdigitation zone,ellipsoid layer,and toward the external limiting membrane.At the site of extrafoveal lesions,SD-OCT revealed the presence of discontinuities or disruptions centered on the ellipsoid zone to include the interdigitation.Conclusions In MEWDS patients,fundus photography showed foveal orange-red granularity;FFA showed early fluorescent dots distributed in a ring pattern;ICGA showed hypofluorescent lesions in the later stage;SD-OCT showed disruption of the interdigitation zone and ellipsoid zone and accumulations of hyperreflective material that was of variable size and shape;FAF showed strong autofluoresce areas that correlated to spots observed with FFA and ICGA.

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