Skip to main content
Log in

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

  • Case Report
  • Published:
International Ophthalmology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

References

  1. Jampol LM, Sieving PA, Pugh D, Fishman GA, Gilbert H (1984) Multiple evanescent white dot syndrome. I. Clinical findings. Arch Ophthalmol 102:671–674

    Article  CAS  PubMed  Google Scholar 

  2. Jampol LM, Wiredu A (1995) MEWDS, MFC, PIC, AMN, AIBSE, and AZOOR: one disease or many? Retina 15:373–378

    Article  CAS  PubMed  Google Scholar 

  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 77:452–455

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  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 58:177–187

    Article  CAS  PubMed  Google Scholar 

  5. Li D, Kishi S (2009) Restored photoreceptor outer segment damage in multiple evanescent white dot syndrome. Ophthalmology 116:762–770

    Article  PubMed  Google Scholar 

  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 252:1645–1651

    Article  PubMed  Google Scholar 

  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 34:359–364

    Article  PubMed  Google Scholar 

  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 158–165

    Google Scholar 

Download references

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.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kazuki Kuniyoshi.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kuniyoshi, K., Sakuramoto, H., Sugioka, K. et al. Long-lasting, dense scotoma under light-adapted conditions in patient with multiple evanescent white dot syndrome. Int Ophthalmol 36, 601–605 (2016). https://doi.org/10.1007/s10792-015-0163-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-015-0163-6

Keywords

Navigation