Features and function of multiple evanescent white dot syndrome.
OBJECTIVE
To describe and compare the tomographic features and macular abnormalities of multiple evanescent white dot syndrome (MEWDS) during the disease course.


METHODS
In 5 patients (5 eyes) with characteristic MEWDS lesions (hypofluorescent in the late phase of indocyanine green angiography [IA]), results of microperimetric retinal sensitivity examination and IA were compared with findings from enhanced spectral-domain optical coherence tomography (SD-OCT) at diagnosis and until clinical resolution.


RESULTS
Enhanced SD-OCT revealed moderately reflective focal lesions within the outer photoreceptor layer, where the inner and outer segment junction was disrupted, that corresponded with hypofluorescent areas in the late phase of IA. Areas of decreased retinal sensitivity on microperimetric examination matched areas of disruption in the inner/outer segment junction on SD-OCT images. In the first month after diagnosis, microperimetric examination and enhanced SD-OCT showed a shift in areas of decreased retinal sensitivity and disruption in the inner/outer segment junction from around the optic disc to the temporal macula. Retinal sensitivity and the inner/outer segment junction returned to almost normal in all eyes about a month after diagnosis of MEWDS.


CONCLUSIONS
Enhanced SD-OCT revealed abnormalities in the photoreceptor layer that were specific to MEWDS and that, with retinal shape and function, seemed to change location during clinical recovery from MEWDS.
Hangai
Masanori
M
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan. hangai@kuhp.kyoto-u.ac.jp
Fujimoto
Masahiro
M
Yoshimura
Nagahisa
N
D000328:Adult; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D008875:Middle Aged; D020419:Photoreceptor Cells, Vertebrate / Q000473:pathology*; D012164:Retinal Diseases / Q000175:diagnosis* / Q000503:physiopathology*; D012607:Scotoma / Q000503:physiopathology*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology*; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology
D004396:Coloring Agents; D007208:Indocyanine Green