title: Multimodal imaging findings in 'hyper-early' stage MEWDS.
abstract: To describe a new stage of multiple evanescent white dot syndrome (MEWDS), occurring at a very early phase of the disease.
  
  
  
  Retrospective analysis of clinical, angiographic and tomographic findings in four patients with 'hyper-early' stage MEWDS.
  
  
  
  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.
  
  
  
  We have shown a new feature of MEWDS on FAF, OCT, FA and ICGA, corresponding to a very early stage of the disease.
authors.affiliation: Fondation Ophtalmologique Adolphe de Rothschild (FOR), 25 rue Manin, Paris Cedex 19, Île-de-France, France.
authors.forename: Armelle
authors.initials: A
authors.lastname: Cahuzac
authors.affiliation: Fondation Ophtalmologique Adolphe de Rothschild (FOR), 25 rue Manin, Paris Cedex 19, Île-de-France, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Wolff
authors.affiliation: Service d'Ophtalmologie de l'Hôpital de la Croix-Rousse, 103 Grand rue de la Croix-Rousse, Lyon, Rhône-Alpes, France.
authors.forename: Thibaud
authors.initials: T
authors.lastname: Mathis
authors.affiliation: Centre Hospitalier National d'Ophtalmologique des Quinze-Vingts, Paris, France.
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Errera
authors.affiliation: Fondation Ophtalmologique Adolphe de Rothschild (FOR), 25 rue Manin, Paris Cedex 19, Île-de-France, France.
authors.forename: José-Alain
authors.initials: JA
authors.lastname: Sahel
authors.affiliation: Fondation Ophtalmologique Adolphe de Rothschild (FOR), 25 rue Manin, Paris Cedex 19, Île-de-France, France.
authors.forename: Martine
authors.initials: M
authors.lastname: Mauget-Faÿsse
mesh_terms: D000328:Adult; D004396:Coloring Agents / Q000008:administration & dosage; D005260:Female; D005451:Fluorescein Angiography; D005584:Fovea Centralis / Q000000981:diagnostic imaging / Q000473:pathology; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D064847:Multimodal Imaging; D061848:Optical Imaging / Q000379:methods*; D012164:Retinal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D004396:Coloring Agents
keywords: Imaging; Retina