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International Ophthalmology

, Volume 38, Issue 5, pp 2153–2158 | Cite as

Bilateral multiple evanescent white dot syndrome

  • Chiara Veronese
  • Chiara Maiolo
  • Mariachiara Morara
  • Grayson W. Armstrong
  • Antonio P. Ciardella
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Abstract

Purpose

To present a single case of bilateral multiple evanescent white dot syndrome (MEWDS).

Methods

A single case with three months of follow-up using imaging studies including fundus color photography (FP), fluorescein angiography (FA), indocyanine green angiography (ICGA), fundus autofluorescence (FAF), spectral-domain optical coherence tomography (SD-OCT), en face SD-OCT and optical coherence tomography angiography (OCTA) is presented.

Results

The patient presented with bilateral MEWDS, ultimately with complete resolution of symptoms. FP revealed foveal granularity and white punctate deep retinal spots, FA found early wreath-like hyperfluorescence, while ICGA showed hypofluorescent dots and spots in the early and late stages. FAF showed areas of hyperautofluorescence. SD-OCT revealed disruption of the ellipsoid zone (EZ) and accumulation of hyperreflective material of variable size and shape. En face SD-OCT demonstrated hyporeflective areas corresponding to areas of EZ disruption as well as hyperreflective dots in the outer nuclear layer. OCTA showed areas of photoreceptor slab black-out corresponding to areas of EZ disruption and light areas of flow void or flow disturbance in the choriocapillaris slab.

Conclusions

This case represents an unusual case of bilateral MEWDS with complete resolution within three months.

Keywords

Bilateral multiple evanescent white dot syndrome En face SD-OCT Fundus autofluorescence OCTA 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

References

  1. 1.
    Marsiglia M, Gallego-Pinazo R, Cunha de Souza E et al (2016) Expanded clinical spectrum of multiple evanescent white dot syndrome with multimodal imaging. Retina 36:64–74CrossRefPubMedCentralGoogle Scholar
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    Gaudric A, Mrejen S (2017) Why the dots are black only in the late phase of the indocyanine green angiography in multiple evanescent white dot syndrome. Retina Cases Brief Rep Suppl 1:S81–S88CrossRefGoogle Scholar
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    De Bats F, Wolff B, Vasseur V et al (2014) “En-face” spectral-domain optical coherence tomography findings in multiple evanescent white dot syndrome. J Ophthalmol 2014:928028PubMedPubMedCentralGoogle Scholar
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    Aaberg TM, Campo RV, Joffe L (1985) Recurrences and bilaterality in the multiple evanescent white-dot syndrome. Am J Ophthalmol 100:29–37CrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  • Chiara Veronese
    • 1
  • Chiara Maiolo
    • 2
  • Mariachiara Morara
    • 1
  • Grayson W. Armstrong
    • 3
  • Antonio P. Ciardella
    • 1
  1. 1.Ophthalmology Unit, S. Orsola-Malpighi HospitalUniversity of BolognaBolognaItaly
  2. 2.University of BolognaBolognaItaly
  3. 3.Ophthalmology DepartmentMassachusetts Eye and Ear Infirmary/Harvard Medical SchoolBostonUSA

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