Photoreceptor inner and outer segment layer thickness in multiple evanescent white dot syndrome
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Abstract
Purpose
To evaluate the photoreceptor inner and outer segment layer thickness in eyes with MEWDS.
Design
Prospective, non-comparative, observational case series. The follow-up duration was 4 months.
Methods
Four women were diagnosed with unilateral MEWDS. The ages of the patients were 25, 24, 35, and 40 years. The retinal microstructure was assessed by spectral-domain optical coherence tomography (SD-OCT). The thickness of the photoreceptor inner (IS) and outer (OS) segments and sum of them (IS + OS) at the fovea were analyzed.
Results
The visual acuity was reduced in three of four eyes at the acute phase. SD-OCT showed that the border of IS and OS (IS/OS) line and the cone outer segment tips (COST) line in the macula area were not detected in all four eyes. The IS + OS thickness was 50.3 ± 5.6 μm and that of the healthy fellow eyes was 73.5 ± 7.0 μm (n = 4 eyes). The thickness of the IS was 27.8 ± 2.6 μm and that of the OS was 45.8 ± 7.3 μm. In all eyes, there was a spontaneous improvement of the visual acuity. SD-OCT showed a recovery of only the IS/OS line in the macular area, but the COST line was not visible in three cases. The mean IS + OS thickness increased to 56.0 ± 7.9 μm (n = 4), IS = 26.0 ± 2.0 μm (n = 3), and OS = 30.1 ± 8.7 μm (n = 3) in the early recovery phase, and to 64.8 ± 9.3 μm (n = 4), IS = 28.5 ± 1.7 μm (n = 4), and OS = 36.3 ± 7.9 μm (n = 4) in the late recovery phase. The mean inner and outer segment thickness remained unchanged in the fellow eyes.
Conclusion
Eyes with MEWDS have changes in the photoreceptor microstructures. The change in the IS + OS thickness during the natural recovery course might be due to an increase in the OS length.
Keywords
Multiple evanescent white dot syndrome Photoreceptor inner and outer segment Cone outer segment tips Multifocal electroretinogram Optical coherence tomographyNotes
Acknowledgments
Funding/support
Support of this study was provided by Researches on Sensory and Communicative Disorders from the Ministry of Health, Labor, and Welfare, Japan.
Disclosure statement
No author has a financial or proprietary interest in any material or method mentioned.
Conflict of interest
None
Data access and responsibility
The corresponding author (KShinoda) has full access to all of the data in the study, and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Contributions of authors
Conception and design of study (R.A., I.K., K.Shinoda); conduct of study (R.A., I.K.,Y.I., K.Shinoda); collection of data (K.Shinoda.,Y.I., K.Seki., M.I., A.Mizota); analysis and interpretation of data (R.A., I.K.,Y.I., K.Shinoda); preparation of the manuscript (Y.I., K.Shinoda); critical revision (Y.I., CS.M.); obtain funding (K.Shinoda, A.Mizota.); literature search (K.Shinoda, Y.I.); administrative support (M.I., A.Murakami, A.Mizota.); and review and approval of the manuscript (R.A., I.K.,Y.I., K.Shinoda., CS.M., K.Seki. M.I.,A.Murakami., A.Mizota.)
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