TY - JOUR
T1 - Expanded clinical spectrum of multiple evanescent white dot syndrome with multimodal imaging
AU - Marsiglia, Marcela
AU - Gallego-Pinazo, Roberto
AU - De Souza, Eduardo Cunha
AU - Munk, Marion R.
AU - Yu, Suquin
AU - Mrejen, Sarahmd
AU - Cunningham, Emmett T.
AU - Lujan, Brandon J.
AU - Naomi, R. Goldberg
AU - Albini, Thomas A.
AU - Gaudric, Alain
AU - Francais, Catherine
AU - Rosen, Richard B.
AU - Freund, K. Bailey
AU - Jampol, Lee M.
AU - Yannuzzi, Lawrence A.
PY - 2016
Y1 - 2016
N2 - 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.
AB - 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.
KW - Autofluorescence
KW - Fluorescein angiography
KW - Indocyanine green angiography
KW - MEWDS
KW - Multimodal imaging
KW - Multiple evanescent white dot syndrome
KW - Optical coherence tomography
KW - Posterior uveitis
KW - Retina
KW - Uveitis
UR - http://www.scopus.com/inward/record.url?scp=84952891548&partnerID=8YFLogxK
U2 - 10.1097/IAE.0000000000000685
DO - 10.1097/IAE.0000000000000685
M3 - Article
C2 - 26166804
AN - SCOPUS:84952891548
SN - 0275-004X
VL - 36
SP - 64
EP - 74
JO - Retina
JF - Retina
IS - 1
ER -