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

Int Ophthalmol. 2016 Aug;36(4):601-5. doi: 10.1007/s10792-015-0163-6. Epub 2015 Dec 17.

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

Publication types

  • Case Reports

MeSH terms

  • Adaptation, Ocular*
  • Adult
  • Dark Adaptation
  • Electroretinography
  • Female
  • Humans
  • Retinal Cone Photoreceptor Cells / pathology*
  • Retinal Diseases / diagnosis*
  • Scotoma / diagnosis*
  • Tomography, Optical Coherence
  • Visual Acuity / physiology
  • Visual Field Tests
  • Visual Fields / physiology