Advertisement

International Ophthalmology

, Volume 36, Issue 4, pp 601–605 | Cite as

Long-lasting, dense scotoma under light-adapted conditions in patient with multiple evanescent white dot syndrome

  • Kazuki Kuniyoshi
  • Hiroyuki Sakuramoto
  • Koji Sugioka
  • Chota Matsumoto
  • Shunji Kusaka
  • Yoshikazu Shimomura
Case Report
  • 209 Downloads

Abstract

To report the light- and dark-adapted perimetric findings in a patient with multiple evanescent white dot syndrome (MEWDS). The patient was a 25-year-old Japanese woman who underwent comprehensive ophthalmological examinations including measurements of the visual acuity, dilated ophthalmoscopy, Goldmann kinetic perimetry, electroretinography (ERG), indocyanine green fundus angiography (ICGA), and optical coherence tomography (OCT). Kinetic perimetry was performed under light- and dark-adapted conditions. The patient was diagnosed with MEWDS by the fundus and visual field findings, and the ICGA abnormalities. Light-adapted perimetry showed an enlargement of the blind spot; however, the size of the blind spot was normalized with dark-adaptation. Amplitude of cone ERG was more reduced than that of rod ERG in the affected eye. The OCT images showed multiple disruptions of the ellipsoid and interdigitation zones. These abnormalities were still present 9 months after the onset although the fundus appeared normal. These findings indicate a persistent cone-dominated dysfunction in a patient with MEWDS.

Keywords

Multiple evanescent white dot syndrome Perimetry Light adaptation Cones Optical coherence tomography Electroretinography 

Notes

Acknowledgments

The authors express gratitude to Miyuki Oosato M.D. of Oosato Eye Clinic who referred the patient to our clinic, and Kazuyo Nakada-Omure C.O. of Department of Ophthalmology, Kinki University Faculty of Medicine for her technical assistance, and Professor Duco I. Hamasaki of the Bascom Palmer Eye Institute of the University of Miami for critical discussions and final manuscript editing. This research was supported by the research grants to SK from Japan Society for the Promotion of Science, Japan (26462654). The authors have no proprietary interest in any aspect of this report.

References

  1. 1.
    Jampol LM, Sieving PA, Pugh D, Fishman GA, Gilbert H (1984) Multiple evanescent white dot syndrome. I. Clinical findings. Arch Ophthalmol 102:671–674CrossRefPubMedGoogle Scholar
  2. 2.
    Jampol LM, Wiredu A (1995) MEWDS, MFC, PIC, AMN, AIBSE, and AZOOR: one disease or many? Retina 15:373–378CrossRefPubMedGoogle Scholar
  3. 3.
    Horiguchi M, Miyake Y, Nakamura M, Fujii Y (1993) Focal electroretinogram and visual field defect in multiple evanescent white dot syndrome. Br J Ophthalmol 77:452–455CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Kuniyoshi K, Sakuramoto H, Nakao Y, Matsumoto C, Shimomura Y (2014) Two types of acute zonal occult outer retinopathy differentiated by dark- and light-adapted perimetry. Jpn J Ophthalmol 58:177–187CrossRefPubMedGoogle Scholar
  5. 5.
    Li D, Kishi S (2009) Restored photoreceptor outer segment damage in multiple evanescent white dot syndrome. Ophthalmology 116:762–770CrossRefPubMedGoogle Scholar
  6. 6.
    Arai R, Kimura I, Imamura Y, Shinoda K, Matsumoto CS, Seki K, Ishida M, Murakami A, Mizota A (2014) Photoreceptor inner and outer segment layer thickness in multiple evanescent white dot syndrome. Graefes Arch Clin Exp Ophthalmol 252:1645–1651CrossRefPubMedGoogle Scholar
  7. 7.
    Neri P, Ricci F, Giovannini A, Arapi I, De Felici C, Cusumano A, Mariotti C (2014) Successful treatment of an overlapping choriocapillaritis between multifocal choroiditis and acute zonal occult outer retinopathy (AZOOR) with adalimumab (Humira™). Int Ophthalmol 34:359–364CrossRefPubMedGoogle Scholar
  8. 8.
    Kuniyoshi K (2015) AZOOR and AZOOR complex. In: Matsumoto C (ed) Visual field tests. The series of ophthalmology handbook “Ganka Rinsho Qualify”. Nakayama Shoten Co. Ltd., Tokyo, pp 158–165Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2015

Authors and Affiliations

  • Kazuki Kuniyoshi
    • 1
  • Hiroyuki Sakuramoto
    • 1
  • Koji Sugioka
    • 1
  • Chota Matsumoto
    • 1
  • Shunji Kusaka
    • 1
    • 2
  • Yoshikazu Shimomura
    • 1
  1. 1.Department of OphthalmologyKinki University Faculty of MedicineOsaka-Sayama CityJapan
  2. 2.Department of OphthalmologySakai Hospital, Kinki University Faculty of MedicineSakai CityJapan

Personalised recommendations